The laparoscope and the undescended testis

An empty scrotum with an impalpable testis/testes presents a difficult diagnostic and therapeutic problem. Many methods have been used in an attempt at, or as an aid to, the localization of these gonads including venography, ultrasonography, hormone manipulation, and surgical exploration. Laparoscopy has been recommended as an aid to diagnosis. We reviewed our experience with the laparoscope in the diagnosis and management of this problem over a 7-year period. Laparoscopy permitted planning of the approach to orchidopexy, depending on whether the vessels entered the deep inguinal ring. In the latter group 48% of the testes were found to be atrophic. We also found the laparoscope to be of value in performing the first stage of the Fowler-Stephens long loop vas orchidopexy in three cases, with long-term viability of the testes in two of these.