The clinical utility of laparoscopy in the management of impalpable testes in pediatric age group

Abstract EN

Background Laparoscopy is proposed to play a major role in the management of impalpable testes in pediatrics.

The Objectives of the study is to assess the role of laparascopy in the management of impalpable testes.

Methods A prospective study for 49 impalpable testes (46 patients) in which three patients had bilateral impalpable testes.

All of these patients underwent diagnostic laparoscope in the Pediatric Surgery Center at Al-Khansaa Teaching Hospital from the period between July 2008 and January 2012.

All these patients were proved to have impalpable testes whether unilateral or bilateral by clinical examination.

Results Five testes (10.2%) were palpated after anesthesia so traditional orchiopexy were performed.

These patients were excluded from the study.

Eleven (25%) from the remaining 44 testes were vanished.

33(75%) testes were identified intraabdominally at different sites, Ten (22.7%) were near the internal inguinal ring and directly fixed, Eleven (25%) were fixed after extensive release of the cord, Seven (15.9%) fixed after cutting the testicular vessels, and Five (11.3%) after staged surgery and these were discharged home a day after surgery.

There were no intra operative and immediate post laparoscopic complications.

Follow up from six months to two years showed that the testes were located in a normal scrotal position, but four (9%) were smaller than the contralateral ones.

Conclusions The laparoscopic management of impalpable testes is the most useful method with excellent results and low morbidity.

Moreover, it is quick and easy in dealing with all varieties of impalpable testes.