title: [Management of the impalpable testis in children].
abstract: OBJECTIVE
  To explore the management of the impalpable testis in children.
  
  
  METHODS
  From April 2003 to August 2005, 36 children aged 20 months to 8 years with impalpable testes underwent inguinal and laparoscopy explorations. The clinical data were reviewed, including the indications of laparoscopy and inguinal explorations and the correspondence between the ultrasonic and surgical
  
  
  RESULTS
  Of the 36 cases (36 / 361 ) of impalpable testis (41 testes), laparoscopy and inguinal explorations revealed 18 results. testes to be vanishing ones, 21 located intra-abdominally and 2 scrotal nubbins. Manifestations were divided into 4 types according to the laparoscopic findings, and 9 testes fell into Type I, 9 Type II, 13 Type III and 10 Type IV. Orchidopexies were performed by traditional and laparoscopic techniques. The positive diagnoses by ultrasound accounted for 75% (27/36). The volumes of the contralateral testes of the cryptorchid children were larger than those with intra-abdominal testes and testicular nubbins. One case of testicular atrophy was detected by ultrasound in the follow-up period.
  
  
  CONCLUSIONS
  Laparoscopy should be performed as a routine in children with impalpable testes. Children with Type II testes need not undergo inguinal exploration. Inguinal and scrotal explorations are necessary for children with Type I testes. Preoperative ultrasonic examination of the contralateral testis helps to evaluate vanishing testes or testicular nubbins.
authors.affiliation: Department of Pediatric Surgery, Shengjing Hospital, Second Affiliated Hospital of China Medical University, Shenyang, Liaoning 110004, China. yangxy70@hotmail.com
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.forename: Ying
authors.initials: Y
authors.lastname: Hou
authors.forename: Chang-lin
authors.initials: CL
authors.lastname: Wang
mesh_terms: D002648:Child; D003456:Cryptorchidism / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D005500:Follow-Up Studies; D006119:Groin / Q000473:pathology; D006801:Humans; D008297:Male; D013737:Testis / Q000473:pathology