Is inguinal exploration for the impalpable testis an outdated operation?
OBJECTIVE
To evaluate the reliability of open inguinal exploration for the investigation of the impalpable testis by reviewing laparoscopic findings after previous negative inguinal exploration.


METHODS
Laparoscopy was performed in 18 boys (with a total of 22 impalpable testes) in whom previous inguinal exploration in their referring hospitals had yielded negative or inconclusive findings. Subsequent management of the impalpable testes was based on laparoscopic findings.


RESULTS
Despite previous negative surgical findings at inguinal exploration, laparoscopy revealed that 13 of the 22 impalpable testes (59%) were present, 12 within the abdomen and one in the inguinal canal. Absence of the remaining nine testes was positively confirmed by visualizing confluent blind ending vas and vessels.


CONCLUSIONS
Inguinal exploration is an unreliable method of investigating the impalpable testis, with an unacceptably high incidence of false-negative or inconclusive findings. Laparoscopy should be undertaken as the initial diagnostic manoeuvre of choice.
Lakhoo
K
K
Department of Paediatric Urology/Surgery, St James's University Hospital, Leeds, UK.
Thomas
D F
DF
Najmaldin
A S
AS
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D006801:Humans; D007264:Inguinal Canal / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D009919:Orchiectomy; D012680:Sensitivity and Specificity