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Laparoscopic orchidopexy: the treatment of choice for the impalpable undescended testis
Objective:
Management of the impalpable testis often represents a significant diagnostic and therapeutic challenge for the radiologist and surgeon. The aim of this work is to present the superior value of laparoscopy as a single tool for the diagnosis and treatment of the impalpable testis.
Methods And Procedures:
Thirty-three patients with 43 impalpable testes are included in this study. For each patient, magnetic resonance imaging (MRI) then laparoscopy were performed. Either the testis or blind-ending cord structures are searched for. The testis was either brought down to the scrotum or removed depending on the condition of each patient.
Results:
MRI detected 16 out of 43 impalpable testes (37.2%). Laparoscopy, on the other hand, detected 18 intra-abdominal testes, 7 inguinal and 16 blind-ending cord structures either above or below the internal inguinal ring. Blind-ending cord structures suggested a vanished testis. Orchidopexy was done for 23 cases, orchidectomy in 18 cases and laparoscopy only in 2 cases.
Conclusion:
Laparoscopy seems to offer a safe and reliable diagnostic and therapeutic option to patients with impalpable testes. Intra-abdominal dissection allows more testes to be brought down to the scrotum. The procedure is best viewed as laparoscopy-assisted, as orchidopexy has to be done in a conventional manner.
