[The value of laparoscopy in the diagnosis and treatment of non-palpable testicular cryptorchism].
Laparoscopy is useful in both the diagnosis and the management of impalpable testes. Intra-abdominal testicles can be removed laparoscopically if atrophic or can be partly devascularized by spermatic vessel clipping if apparently normal. Assessment of testicular revascularization would be desirable prior to subsequent orchidopexy. A second-stage vasal-based orchidopexy can then be performed once adequate testicular reperfusion via the deferential pedicle is believed to have occurred. We have used both diagnostic and therapeutic laparoscopy in the management of 103 non-palpable testes over a period of 6 years. Open procedures following laparoscopy included 57 orchidopexies, 11 orchiectomies and one microvascular testicular autotransplant. Thirteen laparoscopic interventions were performed: 5 orchiectomies for atrophic testes and 8 testicular vessel clippings followed by 6 second stage open inguinal orchidopexies. Color Doppler duplex ultrasonography was not found to be reliable for assessment of testicular revascularization following spermatic vessel clipping. There were 3 complications which were all related to puncture with the Veress needle.
Poenaru
D
D
Service d'Urologie Pédiatrique, Hôpital Sainte Justine, Montréal, Canada.
Homsy
Y L
YL
Peloquin
F
F
Andze
G O
GO
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000175:diagnosis* / Q000601:surgery*; D004543:Ejaculatory Ducts / Q000601:surgery; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D010173:Palpation; D012092:Replantation; D013737:Testis / Q000002:abnormalities / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D014649:Vas Deferens / Q000601:surgery
Intérêt de la coelioscopie dans l'exploration et le traitement des testicules cryptorchides non palpables.