Nonpalpable testes: is there a relationship between ultrasonographic and operative findings?
BACKGROUND
Ultrasonography (US) as a diagnostic tool in the work-up of boys with nonpalpable testes (NPT) is still controversial.


OBJECTIVE
To evaluate the relation between US and operative findings in boys with NPT.


METHODS
During a 7-year period we saw 135 boys with 152 NPT. All were examined by the referring physician or a paediatric surgeon, underwent US examination, and were then re-examined afterwards by a specialist. Finally, all boys were surgically explored for testicular position.


RESULTS
US located 103 NPT (68%), 16 within the abdomen and 87 in the inguinal canal. With knowledge of the US result, 37 testes were palpable on re-examination. The sensitivity of US was 97% for inguinal and 48% for abdominal viable testes. Of the 49 testes (32%) missed by US, 16 were viable in either the abdominal (n=14) or the inguinal (n=2) position.


CONCLUSIONS
All boys with presumed NPT should be referred to a specialist. US is useful to determine localization of NPT, which facilitates planning the surgical procedure. An inguinal exploration is called for when US identifies the testis in the inguinal canal. Because the sensitivity of US for viable abdominal testes is only 48%, we now always perform laparoscopic exploration when US is negative.
Nijs
Sigrid M P
SM
Department of Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ, Rotterdam, The Netherlands. snijs0@yahoo.com
Eijsbouts
Sebastiaan W
SW
Madern
Gerard C
GC
Leyman
Paul M M
PM
Lequin
Maarten H
MH
Hazebroek
Frans W J
FW
D000293:Adolescent; D001284:Atrophy; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007223:Infant; D007264:Inguinal Canal / Q000000981:diagnostic imaging; D010535:Laparoscopy; D008297:Male; D010173:Palpation; D010347:Patient Care Planning; D012189:Retrospective Studies; D012611:Scrotum / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D013737:Testis / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography; D014649:Vas Deferens / Q000002:abnormalities