[The value of examination and treatment using laparoscopy in non-palpable testes: apropos of a series of 48 cases].
OBJECTIVE
Laparoscopy now constitutes the reference technique for the diagnosis and treatment of cryptorchid testes. We report our experience over the last three years (1993-1996).


METHODS
48 strictly impalable testes were investigated in 46 boys between the ages of 11 months and 14.5 years (mean age: 40 months). The intraperitoneal investigation assessed both deep inguinal regions looking for gonads, vas deferens and pedicles. Intra-abdominal gonads were ligated and their pedicle was sectioned laparoscopically allowing transinguinal descent 6 months later according to the Fowler-Stephens technique.


RESULTS
We found 21 cases of typical antenatal torsion, including one bilateral case (pedicle and vas deferens present, but gonad absent), one case of total unilateral agenesis and 3 cases of incomplete agenesis (only the vas deferens was detected) and performed three resections of the gonadal rest for histological examination. The first-stage of cryptorchid testis descent was performed in 20 cases, by laparoscopy in 19 cases (1 failure of insufflation). Definitive descent was possible in 13 cases, with early onset of atrophy in only one case.


CONCLUSIONS
Laparoscopy is therefore a simple technique, allowing a definitive diagnosis and two-stage descent without increasing the risk of testicular atrophy.
Bugel
H
H
Clinique Chirurgicale Infantile, Hôpital Charles Nicolle, Rouen, France.
Pfister
C
C
Liard-Zmuda
A
A
Bachy
B
B
Mitrofanoff
P
P
D000293:Adolescent; D001284:Atrophy; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000175:diagnosis* / Q000601:surgery; D006059:Gonadal Dysgenesis / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007223:Infant; D007264:Inguinal Canal / Q000473:pathology; D007327:Insufflation / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects; D008026:Ligation; D008297:Male; D010537:Peritoneum / Q000473:pathology; D012307:Risk Factors; D013085:Spermatic Cord / Q000473:pathology; D013086:Spermatic Cord Torsion / Q000175:diagnosis / Q000601:surgery; D013737:Testis / Q000002:abnormalities / Q000473:pathology; D016896:Treatment Outcome; D014649:Vas Deferens / Q000473:pathology
Intérêt de l'exploration et du traitement par coelioscopie des testicules impalpables: à propos d'une série de 48 cas.