title: [Impalpable testis: value of one-stage surgical descent].
abstract: OBJECTIVE
  The objective of this retrospective study was to assess the value of one-stage testicular descent without spermatic vessel ligation for intraabdominal impalpable testis.
  
  
  METHODS
  This study was based on 90 children with 98 impalpable testes. Laparoscopic exploration was performed in each case. Forty-three testes were intra-abdominal and 55 were absent. One-stage surgical descent with vertical opening of the conjoined tendon and without spermatic vessel ligation was performed for 22 testes and two-stage descent (Fowler-Stephens two-stage technique) was performed for 16 testes. Three testes in bilateral forms are still waiting for treatment.
  
  
  RESULTS
  With a mean follow-up of 17 months (range: 1 month to 8 years), 18 of the 22 testes (81%) were situated in the scrotum and were viable in the one-stage treatment group, versus 10 out of 16 (62.5%) in the two-stage group. Two poor results, including one case of necrosis, were observed after one-stage testicular descent. Six poor results, including two cases of necrosis, were observed after the Fowler-Stephens two-stage technique.
  
  
  CONCLUSIONS
  One-stage testicular descent, without spermatic vessel ligation, after laparoscopic assessment of the presence and position of the testis, can be performed in the majority of cases of impalpable testis. The risks of failure due to secondary atrophy or incomplete testicular descent are minimal with this technique. One-stage surgical descent, when possible, appears to be preferable to the Fowler-Stephens two-stage procedure.
authors.affiliation: Service de Chirurgie Viscérale Infantile, Hôpital d'Enfants Armand-Trousseau, Paris, France.
authors.forename: Malika
authors.initials: M
authors.lastname: Ait Ali Slimane
authors.forename: Frédéric
authors.initials: F
authors.lastname: Auber
authors.forename: Philine
authors.initials: P
authors.lastname: De Vries
authors.forename: Henri
authors.initials: H
authors.lastname: Kotobi
authors.forename: Michelle
authors.initials: M
authors.lastname: Larroquet
authors.forename: Christine
authors.initials: C
authors.lastname: Grapin
authors.forename: Georges
authors.initials: G
authors.lastname: Audry
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013521:Urologic Surgical Procedures, Male / Q000379:methods