title: The value of ultrasonography in boys with a non-palpable testis.
abstract: BACKGROUND
  In patients with a non-palpable testis (NPT) on physical examination, the testis is assumed either to be situated intra-abdominally or to be hypoplastic or absent. Diagnostic laparoscopy in these boys is considered the preferable first step. In this study the diagnostic value of pre-operative ultrasound for NPT is assessed in comparison with laparoscopy.
  
  
  METHODS
  All boys aged under the age of 17 years who were diagnosed with an NPT by a pediatric surgeon from 2000 till 2012 were evaluated. All patients of whom clinical, ultrasonographic, and operative findings were available were included.
  
  
  RESULTS
  Ninety-six boys with 117 NPTs were included. With ultrasound 67 testes were detected in the inguinal canal, which was confirmed peroperatively for 61 testes. Of the 15 testes with an intra-abdominal position on ultrasound, 10 were found intra-abdominally during surgery. The positive predictive value of the ultrasonography is 91% for inguinally located testes and 67% for intra-abdominally located testes.
  
  
  CONCLUSIONS
  Ultrasonography has a high positive predictive value for inguinally located testes. When ultrasound locates a testis in an inguinal location, a primary inguinal exploration can be considered, preventing an unnecessary diagnostic laparoscopy.
authors: Pediatric Surgical Center of Amsterdam, Emma Children's Hospital AMC and VU University Medical Center, Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: alexandergvos@gmail.com.
authors: Alexander
authors: A
authors: Vos
authors: Pediatric Surgical Center of Amsterdam, Emma Children's Hospital AMC and VU University Medical Center, Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors: Annebeth Meij-de
authors: AM
authors: Vries
authors: Academic Medical Center, Radiology department, Amsterdam, The Netherlands.
authors: Anne
authors: A
authors: Smets
authors: VU University Medical Center, Radiology Department, Amsterdam, The Netherlands.
authors: Jonathan
authors: J
authors: Verbeke
authors: Pediatric Surgical Center of Amsterdam, Emma Children's Hospital AMC and VU University Medical Center, Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors: Hugo
authors: H
authors: Heij
authors: Pediatric Surgical Center of Amsterdam, Emma Children's Hospital AMC and VU University Medical Center, Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: a.f.vandersteeg@amc.uva.nl.
authors: Alida
authors: A
authors: van der Steeg
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D011237:Predictive Value of Tests; D011300:Preoperative Care; D013737:Testis / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography
keywords: Diagnostic laparoscopy; Inguinal exploration; Non-palpable testis; Ultrasound