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Adult nonpalpable testis: is laparoscopy always required?
Coskun Sahin1, Taner Yigit, Isa Ozbey
1Department of Urology, Maresal Cakmak Military Hospital, Erzurum, Turkey. drcoskunsahin@yahoo.com
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|February 20, 2003
Summary
Laparoscopy can be avoided in adult nonpalpable testes cases with palpable scrotal nubbins and hypertrophic contralateral testes. Careful patient selection prevents unnecessary laparoscopic interventions for vanishing testes.
Area of Science:
- Urology
- Pediatric Surgery
Background:
- Nonpalpable testes are common, with laparoscopy frequently used for diagnosis and treatment.
- A subset of nonpalpable testes are vanishing testes, where surgical intervention may be unnecessary.
Purpose of the Study:
- To evaluate the utility of clinical and radiological assessment in identifying vanishing testes in adults.
- To determine criteria for selecting patients who would benefit from laparoscopic intervention for nonpalpable testes.
Main Methods:
- Retrospective analysis of 107 adult patients (19-27 years) with nonpalpable testes undergoing laparoscopy (1996-2001).
- Comparison of scrotal nubbin and abdominal testis dimensions with a control group using the Prader orchiometer.
- Statistical evaluation using the Mann-Whitney U test to compare hypertrophic contralateral testes in vanishing vs. intraabdominal testes groups.
Main Results:
- Laparoscopy revealed vanishing testes in 28.5% (24/107) of patients.
- No testes were found in patients with palpable scrotal nubbins (18/84).
- Hypertrophic contralateral testes were significantly more common in patients with vanishing testes (70.8%) compared to those with intraabdominal testes (36%).
Conclusions:
- Clinical and radiological diagnosis, including assessment of scrotal nubbins and contralateral testis hypertrophy, is sufficient for adult nonpalpable testes.
- Laparoscopic intervention should be reserved for adult patients without palpable scrotal nubbins.