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Laparoscopic Orchidopexy: The Treatment of Choice for the Impalpable Undescended Testis

Authors
Journal
JSLS Journal of the Society of Laparoendoscopic Surgeons
1086-8089
Publisher
The Society of Laparoendoscopic Surgeons
Publication Date
Keywords
  • Scientific Papers
Disciplines
  • Medicine

Abstract

Objective: Management of the impalpable testis often represents a significant diagnostic and therapeutic challenge for the radiologist and surgeon. The aim of this work is to present the superior value of laparoscopy as a single tool for the diagnosis and treatment of the impalpable testis. Methods and Procedures: Thirty-three patients with 43 impalpable testes are included in this study. For each patient, magnetic resonance imaging (MRI) then laparoscopy were performed. Either the testis or blindending cord structures are searched for. The testis was either brought down to the scrotum or removed depending on the condition of each patient. Results: MRI detected 16 out of 43 impalpable testes (37.2%). Laparoscopy, on the other hand, detected 18 intra-abdominal testes, 7 inguinal and 16 blindending cord structures either above or below the internal inguinal ring. Blindending cord structures suggested a vanished testis. Orchidopexy was done for 23 cases, orchidectomy in 18 cases and laparoscopy only in 2 cases. Conclusion: Laparoscopy seems to offer a safe and reliable diagnostic and therapeutic option to patients with impalpable testes. Intra-abdominal dissection allows more testes to be brought down to the scrotum. The procedure is best viewed as laparoscopy-assisted, as Orchidopexy has to be done in a conventional manner.

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