World Journal of Laparoscopic Surgery

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VOLUME 14 , ISSUE 3 ( September-December, 2021 ) > List of Articles

Original Article

Laparoscopic Diagnosis and Treatment of Nonpalpable Testes in a Tertiary Care Center

Neha S Shenoy, Beejal V Sanghvi, Rujuta Shah, Somak K Biswas, Sandesh V Parelkar

Keywords : Laparoscopy, Nonpalpable testes, Testicular units, Undescended

Citation Information : Shenoy NS, Sanghvi BV, Shah R, Biswas SK, Parelkar SV. Laparoscopic Diagnosis and Treatment of Nonpalpable Testes in a Tertiary Care Center. World J Lap Surg 2021; 14 (3):157-161.

DOI: 10.5005/jp-journals-10033-1476

License: CC BY-NC 4.0

Published Online: 05-03-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Background: Cryptorchidism is the commonest genitourinary anomaly in boys. Laparoscopy has been the mainstay for the management of nonpalpable testis. Aim and objective: This study has been done to assess the role of laparoscopy in diagnosing and treating nonpalpable testes. Materials and methods: Medical records of 160 patients of laparoscopic testicular exploration, during a 10-year period, were retrospectively analyzed. All 160 boys with 320 testicular units were examined prior to surgery—118 of the 320 testicular units were normally descended (37%), 9 had palpable undescended testicular units (3%), and 193 testicular units (60%) were nonpalpable. Results: After laparoscopy, 111 of the 193 nonpalpable testicular units were found to be intra-abdominal, 32 were atrophic testes, 22 were peeping testes, 19 were intracanalicular, and 9 were vanishing testes. Of the 111 intra-abdominal testicular units according to the location in relation to the deep inguinal ring, 51 of the testicular units were located within 2 cm from the deep inguinal ring. Among these, 49 cases underwent single-stage laparoscopic orchidopexy and 2 patients required laparoscopic mobilization followed by open orchidopexy due to long loop vas. Sixty testicular units were found greater than 2 cm from the deep inguinal ring and were managed by two-stage Fowler–Stephens laparoscopic orchidopexy. Conclusion and clinical significance: Laparoscopy is safe and effective in managing nonpalpable testis. Single-stage orchidopexy is the treatment of choice for intra-abdominal testis located within 2 cm from the deep inguinal ring with pliable testicular vessels and two-stage surgery is required for intra-abdominal testis located more than 2 cm from the deep inguinal ring and with nonpliable testicular vessels.

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