Laparoscopy as an aid in diagnosis and management of the impalpable testis

Fourteen children with impalpable testes, 10 bilateral and 4 unilateral, were examined laparoscopically. Eleven testes and two primitive undifferentiated gonads were seen in the abdomen. Exploration of the inguinal canals into which the vasa and testicular vessels were seen passing from the abdomen revealed a further two testes but nine were absent. One testis had atrophied as a result of previous torsion. Inappropriate internal genitalia were seen in two boys with hypospadias. One boy in whom both testes were seen in the abdomen had undergone a previous unsuccessful surgical exploration. None of the children developed any complications from the laparoscopy and the examination failed to reveal only one abdominal testis.