Treatment of impalpable testis – one clinic’s experience

Paweł Osemlak; Tomasz Żądkowski; Błażej Rogowski; Czesław Cielecki; Andrzej Wieczorek; Magdalena Woźniak; Grzegorz Jędrzejewski; Iwona Beń-Skowronek; Paweł Nachulewicz

doi:10.5114/wiitm.2017.67482

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Videosurgery and Other Miniinvasive Techniques

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abstract:

Original paper

Treatment of impalpable testis – one clinic’s experience

Paweł Osemlak

,

Tomasz Żądkowski

,

Błażej Rogowski

,

Czesław Cielecki

,

Andrzej Wieczorek

,

Magdalena Woźniak

,

Grzegorz Jędrzejewski

,

Iwona Beń-Skowronek

,

Paweł Nachulewicz

Videosurgery Miniinv 2017; 12 (2): 166–171

DOI: https://doi.org/10.5114/wiitm.2017.67482

Online publish date: 2017/04/27

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Introduction: Undescended testes are recognised in 1% to 2% of boys during the first year of life, and about 20% of them are impalpable. Ultrasonography (US) may establish the localisation of the testis but the final diagnosis is usually determined laparoscopically.

Aim: To evaluate long-term results of laparoscopic treatment of boys with impalpable testes and sensitivity of preoperative ultrasound.

Material and methods: Between 2011 and 2015, we operated on 545 boys with undescended testes. Sixty-two of them with 65 impalpable testes were treated laparoscopically – the study group. Mean age was 3.5 years. The study group was divided into 5 groups according to type of treatment. The volume and position of the operated gonad were assessed manually and by ultrasound.

Results: In group 1 testicular agenesis was observed in 19 patients. In group 2 revision of the inguinal canal revealed testicular agenesis in 7 and atrophy in 4 patients. In group 3 conversion to classic orchiopexy was performed in 10 patients. In group 4 one-stage orchiopexy was performed in 9 patients on 12 testes. In group 5 a two-stage F-S procedure was performed in 13 patients. Ten testes in group 4 had a volume in the normal range (84%) and also 10 testes in group 5 (77%).

Conclusions: Laparoscopy in impalpable testes is the procedure of choice and allows definitive management, even when conversion to open procedure is necessary. Sensitivity of preoperative ultrasound is generally about 60% for true intra-abdominal testes, so diagnostic laparoscopy is necessary.

keywords:

Treatment of impalpable testis – one clinic’s experience

Paweł Osemlak , Tomasz Żądkowski , Błażej Rogowski , Czesław Cielecki , Andrzej Wieczorek , Magdalena Woźniak , Grzegorz Jędrzejewski , Iwona Beń-Skowronek , Paweł Nachulewicz

laparoscopy, ultrasound, boys, undescended testes

Paweł Osemlak

,

Tomasz Żądkowski

,

Błażej Rogowski

,

Czesław Cielecki

,

Andrzej Wieczorek

,

Magdalena Woźniak

,

Grzegorz Jędrzejewski

,

Iwona Beń-Skowronek

,

Paweł Nachulewicz