Location and fate of the nonpalpable testis in children

The records of 261 children who were treated surgically for cryptorchidism between 1975 and 1980 were reviewed to determine the incidence, exact location and results of treatment of nonpalpable testes. Of these 261 patients 71 had 80 nonpalpable testes (27 per cent). Of these 80 nonpalpable testes 17 (21 per cent) were determined to be absent at the time of thorough intra-abdominal and retroperitoneal exploration. Of the 63 testes found at surgical exploration 34 (56 per cent) were intra-abdominal (intraperitoneal), 10 (16 per cent) were in a preperitoneal position behind the internal inguinal ring, 15 (24 per cent) were canalicular and 4 (5 per cent) were located in the superficial inguinal area. Seventeen (27 per cent) testes were removed because of postpubertal age, testicular atrophy or anatomic deformity inconsistent with an attempt at orchiopexy. In the remaining testes the success rate of orchiopexy was compared on the basis of the original anatomic location of the testis and the type of surgical procedure performed. Of those testes deemed suitable for orchiopexy 89 per cent in a preperitoneal or more distal location and 74 per cent of intraperitoneal testes were placed successfully in the scrotum.