Laparoscopic management of nonpalpable testes: a multicenter study of the Italian Society of Video Surgery in Infancy.
OBJECTIVE
Diagnostic laparoscopy has changed the surgical approach to nonpalpable testes (NPT). The aim of this study was to determine the value of laparoscopy in managing patients with NPT and to suggest guidelines for the interpretation of laparoscopic findings. The authors report the results of a multicenter study of the Italian Society of Video Surgery in Infancy on laparoscopic management of NPT.


METHODS
Between 1993 and 2001, the authors collected records of 364 patients with NPT who underwent laparoscopy, for a total of 388 testicular units.


RESULTS
Intraabdominal testes were found in 124 (34%) cases, for a total of 137 testes; 83 testicular units were classified as low and 54 as high. A total of 155 (43%) patients had cord structures entering the internal inguinal ring, 79 (22%) had intraabdominal blind-ending cord structures, and 6 (1%) had testicular agenesia.


CONCLUSIONS
Laparoscopy is a valuable tool in diagnosing and treating more than 50% of cases of NPT. The laparoscopic evaluation of abdominal testes can provide indications for the most suitable surgical technique; moreover, in 23% of patients, it makes abdominal exploration unnecessary. The value of laparoscopy is even greater if the anatomical aspect of the internal ring and spermatic cord structures is carefully evaluated.
Papparella
Alfonso
A
Division of Pediatric Surgery, Second University of Naples, 80131 Naples, Italy. alfonso.papparella@unina2.it <alfonso.papparella@unina2.it>
Parmeggiani
Pio
P
Cobellis
Giovanni
G
Mastroianni
Luciano
L
Stranieri
Giuseppe
G
Pappalepore
Nicola
N
Mattioli
Girolamo
G
Esposito
Ciro
C
Lima
Mario
M
D003456:Cryptorchidism / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*