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- Title
Laparoscopic management of impalpable testes: comparison of different techniques.
- Authors
Singh, Rashmi; Rajimwale, Ashok; Nour, Shawqui; Singh, Rashmi R
- Abstract
<bold>Purpose: </bold>Laparoscopy is an important modality for management of impalpable testes. We present long-term outcomes of intra-abdominal testes managed by either single stage orchidopexy or two-stage Fowler Stephen's orchidopexy (FSO) over 12 years.<bold>Methods: </bold>Data were prospectively collected and retrospectively analyzed on patients who underwent laparoscopy for impalpable testes between 1998 and 2010. Demographic data, intra-operative findings, management, histology and follow-up findings were collected and analyzed. Fisher's Exact test was used for statistical analysis.<bold>Results: </bold>Laparoscopy was performed for 168 impalpable testes (78 left, 58 right and 16 bilateral). Patients were between 8 months and 15 years of age (median 1 year 10 months). Ninety-three testes were found to have cord structures entering the inguinal ring (canalicular), 65 were intra-abdominal and 10 had blind ending vas and/or vessel. Fifty-seven (34%) testes were atrophic and underwent orchidectomy; 100 (60%) testes underwent orchidopexy: either two-stage FSO (48) or single stage orchidopexy (52) and 10 (7%) had findings consistent with 'vanishing testes'. Histopathologically, the excised remnants (34%) showed no viable testicular tissue. The follow-up was a median of 8 months (3 months to 6 years). Four patients were lost to follow-up (two each after FSO and single stage orchidopexy) while, two FSO are awaiting follow-up. At follow-up, 36/44 testes (FSO) and 13/13 testes (single stage orchidopexy) are in the scrotum and of good size. Eight testes had atrophied after two-staged FSO.<bold>Conclusion: </bold>Canalicular testes are often difficult to palpate (55%). Laparoscopy allows direct visualization and definitive management. There is no statistically significant difference between the results following single stage orchidopexy or two-stage FSO for impalpable testes.
- Subjects
TESTIS surgery; LAPAROSCOPIC surgery; HEALTH outcome assessment; ORCHIOPEXY; RETROSPECTIVE studies; HISTOPATHOLOGY; SCROTUM; ABDOMINAL surgery; TESTIS abnormalities; COMPARATIVE studies; UROLOGICAL surgery; GONADAL dysgenesis; LAPAROSCOPY; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MEN; RESEARCH; SUTURING; EVALUATION research; TREATMENT effectiveness
- Publication
Pediatric Surgery International, 2011, Vol 27, Issue 12, p1327
- ISSN
0179-0358
- Publication type
journal article
- DOI
10.1007/s00383-011-2970-9