Management of the impalpable testis: a six year review together with a national experience

Postgraduate Medical Journal
E V WilliamsM E Foster

Abstract

The management of undescended testes remains variable, and the use of laparoscopy for localisation is controversial. This study reviews the need for laparoscopy and also assesses the current practice among a cohort of surgeons.A retrospective review of all patients undergoing orchidopexy was performed, together with a postal survey of all members of the Welsh Surgical Society. Of the 139 orchidopexies performed, the testis was deemed impalpable in 39 (28%) cases. All patients were treated with groin exploration, and only in two (5%) patients was the testis not located. From the survey, replies were received from 90 (81%) surgeons, of whom 65 (72%) were still performing orchidopexy. Forty eight (74%) surgeons performed orchidopexy between the age of 2 and 3, and only 32 (36%) performed preoperative investigations. The follow up period was variable with the majority of patients seen at six weeks. Laparoscopy for the impalpable testis is not initially warranted. An inguinal exploration is regarded as the definitive investigation. This has the advantage of providing the diagnosis and treatment in the majority of cases.

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Citations

Jan 3, 2006·Indian Journal of Pediatrics·V V S S Chandrasekharam
Nov 8, 2001·Journal of Endourology
Aug 25, 2012·Indian Journal of Urology : IJU : Journal of the Urological Society of India·Manas Ranjan Pradhan, M S Ansari
Apr 14, 2009·World Journal of Surgery·Khalid IsmailMohamed Hashish
Jan 11, 2007·Seminars in Pediatric Surgery·John M Hutson, Melanie C C Clarke
Sep 10, 2009·Deutsches Ärzteblatt International·Michael J MathersStephan Roth

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