title: Selective use of laparoscopy in nonpalpable undescended testes.
abstract: BACKGROUND
  Approximately, 20% of undescended testes (UDT) are nonpalpable. Surgical management of the nonpalpable testis comprises laparoscopy. The aim of this study was to determine if ultrasonography can be used as a preoperative tool to localize the nonpalpable inguinal testis, eliminating the need for laparoscopy.
  
  
  METHODS
  We identified 46 patients diagnosed with nonpalpable UDT between 2007 and 2012 who underwent an inguino-scrotal ultrasound preoperatively. We analyzed correlations between radiological and surgical findings.
  
  
  RESULTS
  A total of 46 patients (53 UDT), median age 14 months (quartile 1(st): 7; 3(rd): 80) were included. Ultrasound localized the testis as intracanalicular in 24/53 (45.2%), intraabdominal in 10/53 (18.8%), scrotal in 1/53 (1.8%), and could not localize 18/53 (33.9%) testes. In 35/53 (66%) testes, the ultrasound location correlated with the surgical findings (P < 0.001). Ultrasound detection showed 96% sensitivity and 56% specificity for intracanalicular testes.
  
  
  CONCLUSIONS
  The use of preoperative ultrasound in this series was helpful in identifying the location of nonpalpable testes in children. In particular, the ultrasound finding of an intracanalicular testis may preclude the need for laparoscopy.
authors.affiliation: Department of Surgery, Division of Urology, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Yasser Abdulrahman
authors.initials: YA
authors.lastname: Jamalalail
authors.affiliation: Department of Surgery, Division of Urology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Guerra
authors.affiliation: Department of Surgery, Division of Urology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Leonard
keywords: Children; cryptorchidism; diagnosis; ultrasound; undescended testis
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