The value of laparoscopy in the management of non-palpable testis

作者：Papparella A^*; Romano M; Noviello C; Cobellis G; Nino F; Del Monaco C; Parmeggiani P

来源：Journal of Pediatric Urology, 2010, 6(6): 550-554.

DOI：10.1016/j.jpurol.2009.12.010

• Laparoscopy
• Cryptorchidism
• Undescended testis
• Non-palpable testis
• Impalpable testis

Object: To retrospectively review the value of laparoscopy in the management of impalpable testis.
Materials and methods: In 1993-2006, 182 laparoscopies for impalpable testis were performed for a total of 194 testicular units. Five laparoscopic findings were considered: testicular ectopia, intra-abdominal testis, and cord structures that are blind ending, completely absent (agenesis) or entering the internal inguinal ring.
Results: In 62 cases an intra-abdominal testis was found; 18 were classified as high and managed by a laparoscopic Fowler-Stephens procedure. Cord structures entering the inguinal ring were observed in 77 patients and 45 underwent an inguinal exploration: a testis was found in 12 cases and in 33 a remnant was excised. In 35 cases, intra-abdominal blind ending vas and vessels were observed and eight showed testicular agenesis. No major surgical complications were recorded. Follow up ranged from 1 to 3 years.
Conclusions: Our study confirms the value of laparoscopy in the management of non-palpable testis, providing a definitive diagnosis by the direct view of spermatic bundle and testis. Ninety-three patients were managed by laparoscopy only, and in 44 it was essential for the subsequent surgical approach. When the internal inguinal ring is patent and/or normal spermatic vessels are present an inguinal exploration is mandatory.

• 出版日期2010-12