Laparoscopy in the management of nonpalpable testes and intersex states

Cryptorchidism is the most frequent anomaly in sexual development in male children and is frequently detected in diseases that result in ambiguous external genitalia. Laparoscopy has become a minimally invasive procedure in the management of nonpalpable testis. A total of 45 patients (2 to 35 years old) underwent laparoscopy as a diagnostic method in the investigation of nonpalpable testis. Among them, 37 (82%) underwent exploration and a complete correlation between laparoscopy and operative findings was observed. One patient with ambiguous external genitalia was evaluated and laparoscopy showed an intersex state known as true hermaphroditism and a laparoscopic gonadectomy was performed. Based on our experience, in 37% of nonpalpable testes a confirmatory operation is not necessary. The procedure can also be indicated to localize müllerian ducts remnants and gonadal tissue in selected intersex states, and even to perform gonadal biopsies or gonadectomies, in order to avoid open surgical procedure.