Laparoscopy in the management of impalpable testis (Series of 64 Cases)
Background: The undescended testis represents one of the most common disorders of childhood. Laparoscopy has been widely used both in the diagnosis and treatment of non-palpable testis. In this study, we investigated and evaluated the usefulness of laparoscopy in the diagnosis and treatment of no pa...
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doaj-088ad3969fa64856ab44c42da8fa2fa32020-11-24T22:03:05ZengWolters Kluwer Medknow PublicationsAfrican Journal of Paediatric Surgery0189-67252017-01-01144656910.4103/ajps.AJPS_103_08Laparoscopy in the management of impalpable testis (Series of 64 Cases)Khalid A IsmailMohamed H. M. AshourMahmoud A El-AfifiAmel A HashishNagay E El-DosoukyMohamed NegmMohamed S HashishBackground: The undescended testis represents one of the most common disorders of childhood. Laparoscopy has been widely used both in the diagnosis and treatment of non-palpable testis. In this study, we investigated and evaluated the usefulness of laparoscopy in the diagnosis and treatment of no palpable testis. Patients and Methods: From January 2003 to January 2008, we used laparoscopy in the management of 64 patients with 75 impalpable testes. Their ages varied from 1 to 15 years (median age = 4.6 years). The site and the size of the testes were localised by abdominopelvic ultrasonography in all 64 children for accurate diagnosis. One stage laparoscopic orchiopexy was performed in 26 testes, staged Fowler-Stephens orchiopexy was underwent in 17 testes, while laparoscopic orchidectomy was done in 5 testes. Follow-up by clinical examination and colour Doppler ultrasound was performed in every patient who underwent orchiopexy. Results: There were 11 patients with bilateral non-palpable testes. The overall diagnostic agreement of ultrasound with laparoscopy was seen in only 16 out of 75 testes (21.3%). The results of diagnostic laparoscopy were varied and showed various pathological. Conditions and positioned of the testes, such as 20 low intra-abdominal testes (26.6%), 17 testes were high intra-abdominal (22.7%), and 18 testes (24%) entered the inguinal canal. Associated inguinal hernia was present in 4 patients. After a mean follow-up period of 26 months (6 months – 5 years), all testes were in the bottom of the scrotum except 3 testes were retracted to the neck of the scrotum and atrophy of the testis occurred in 2 patients (2.7%). Conclusion: Laparoscopy has proven to be the only diagnostic modality where the findings provide a clear dependable direction for the definitive management of impalpable testes, so it allows an accurate diagnosis and definitive treatment in the same sitting.http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2017;volume=14;issue=4;spage=65;epage=69;aulast=IsmailImpalpable testeslaparoscopyorchiopexy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Khalid A Ismail Mohamed H. M. Ashour Mahmoud A El-Afifi Amel A Hashish Nagay E El-Dosouky Mohamed Negm Mohamed S Hashish |
spellingShingle |
Khalid A Ismail Mohamed H. M. Ashour Mahmoud A El-Afifi Amel A Hashish Nagay E El-Dosouky Mohamed Negm Mohamed S Hashish Laparoscopy in the management of impalpable testis (Series of 64 Cases) African Journal of Paediatric Surgery Impalpable testes laparoscopy orchiopexy |
author_facet |
Khalid A Ismail Mohamed H. M. Ashour Mahmoud A El-Afifi Amel A Hashish Nagay E El-Dosouky Mohamed Negm Mohamed S Hashish |
author_sort |
Khalid A Ismail |
title |
Laparoscopy in the management of impalpable testis (Series of 64 Cases) |
title_short |
Laparoscopy in the management of impalpable testis (Series of 64 Cases) |
title_full |
Laparoscopy in the management of impalpable testis (Series of 64 Cases) |
title_fullStr |
Laparoscopy in the management of impalpable testis (Series of 64 Cases) |
title_full_unstemmed |
Laparoscopy in the management of impalpable testis (Series of 64 Cases) |
title_sort |
laparoscopy in the management of impalpable testis (series of 64 cases) |
publisher |
Wolters Kluwer Medknow Publications |
series |
African Journal of Paediatric Surgery |
issn |
0189-6725 |
publishDate |
2017-01-01 |
description |
Background: The undescended testis represents one of the most common disorders of childhood. Laparoscopy has been widely used both in the diagnosis and treatment of non-palpable testis. In this study, we investigated and evaluated the usefulness of laparoscopy in the diagnosis and treatment of no palpable testis. Patients and Methods: From January 2003 to January 2008, we used laparoscopy in the management of 64 patients with 75 impalpable testes. Their ages varied from 1 to 15 years (median age = 4.6 years). The site and the size of the testes were localised by abdominopelvic ultrasonography in all 64 children for accurate diagnosis. One stage laparoscopic orchiopexy was performed in 26 testes, staged Fowler-Stephens orchiopexy was underwent in 17 testes, while laparoscopic orchidectomy was done in 5 testes. Follow-up by clinical examination and colour Doppler ultrasound was performed in every patient who underwent orchiopexy. Results: There were 11 patients with bilateral non-palpable testes. The overall diagnostic agreement of ultrasound with laparoscopy was seen in only 16 out of 75 testes (21.3%). The results of diagnostic laparoscopy were varied and showed various pathological. Conditions and positioned of the testes, such as 20 low intra-abdominal testes (26.6%), 17 testes were high intra-abdominal (22.7%), and 18 testes (24%) entered the inguinal canal. Associated inguinal hernia was present in 4 patients. After a mean follow-up period of 26 months (6 months – 5 years), all testes were in the bottom of the scrotum except 3 testes were retracted to the neck of the scrotum and atrophy of the testis occurred in 2 patients (2.7%). Conclusion: Laparoscopy has proven to be the only diagnostic modality where the findings provide a clear dependable direction for the definitive management of impalpable testes, so it allows an accurate diagnosis and definitive treatment in the same sitting. |
topic |
Impalpable testes laparoscopy orchiopexy |
url |
http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2017;volume=14;issue=4;spage=65;epage=69;aulast=Ismail |
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