title: Reliance of preoperative scrotal examination versus final operative findings in the evaluation of non-palpable testes.
abstract: OBJECTIVE
  The current study evaluates whether the preoperative scrotal examination in children with non-palpable testes is sufficient in all cases or if laparoscopy is necessary to confirm the examination findings. Are the findings different amongst physicians depending on their level of experience?
  
  
  METHODS
  This retrospective study was done between October 2009 and May 2013. Children with non-palpable testes underwent an examination under anesthesia prior to surgery to feel for a testis or nubbin, followed by a diagnostic laparoscopy to validate the scrotal examination. The test was considered correct if the laparoscopic findings supported the scrotal examination. It was considered incorrect if laparoscopy revealed a different finding.
  
  
  RESULTS
  A total of 74 testes were evaluated. All patients underwent examination under anesthesia by the surgeon and senior resident. The findings were recorded separately. Despite careful examination by experienced surgeons under anesthesia, the scrotal examination was incorrect in 14 patients. Four viable testes would have been missed if laparoscopy had not been performed.
  
  
  CONCLUSIONS
  Laparoscopy should be considered in case of palpable scrotal nubbins to ensure no testis is left within the abdominal cavity.
authors.affiliation: Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. Electronic address: Dominic-Frimberger@ouhsc.edu.
authors.forename: Dominic
authors.initials: D
authors.lastname: Frimberger
authors.affiliation: Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Malm-Buatsi
authors.affiliation: Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Bradley P
authors.initials: BP
authors.lastname: Kropp
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Aston
authors.affiliation: Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Shirley Y
authors.initials: SY
authors.lastname: Godiwalla
authors.affiliation: Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Blake W
authors.initials: BW
authors.lastname: Palmer
mesh_terms: D002675:Child, Preschool; D003456:Cryptorchidism / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010173:Palpation / Q000379:methods*; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012611:Scrotum / Q000473:pathology / Q000601:surgery*; D013737:Testis / Q000601:surgery; D013521:Urologic Surgical Procedures, Male / Q000379:methods*
keywords: Hemosiderin; Laparoscopy; Non-palpable testis; Nubbin