Contribution of laparoscopy in diagnostics and treatment of non-palpable testes

Česká verzia

Authors: David Míka; Ondřej Havránek; David Němec; Jan Krhut
Authors place of work: Ostrava ; Urologické oddělení Fakultní nemocnice
Published in the journal: Ces Urol 2011; 15(3): 167-171
Category: Original article

Summary

Aim:
The aim of the study is to confirm laparoscopy as the first choice method, used for diagnostics and for treatment of non-palpable testes.

Material and methods:
Retrospectively we evaluated a set of 14 children with non–palpable testes, that were treated in our department from 2005 to 2010 in which we carried out laparoscopy. The average age was 31 months (7–96 months). Insufflation of capnoperitoneum was carried out from infraumbilical incision up to pressure 10–12 torr. Capnoperitoneum was established with Veress needle in 10 cases, preparation technique was used in 4 cases. Two 5mm ports were inserted into the abdominal cavity for preparation on both sides in lower quadrants.

Results:
In 7 cases (50%) we found testicle near the deep ring in abdominal cavity, 3× (22%) in inguinal chanel, in 2 cases (14%) we found blindly ending vessels and ductus deferens, 1× (7%) atrophic testicle located in the top of the scrotum and 1× (7%) ectopic testicle in femoral chanel. In 9 cases (64%) we carried out one-stage orchidopexy, from that in one case we dissected internal spermatic vessels according to Fowler-Stephens. In two cases (14%) we carried out two-stage orchidopexy. In one case (7%) orchiectomy was made and in two cases (14%) anorchia was diagnosed. In one case an absces in the wound developed and was treated with drainage and antibiotics. The rest of operations were not complicated.

Conclusion:
The use of laparoscopy carried out in case of non-palpable testes is currently safe and effective method. Its contribution can be very helpful in case of high retention and the anorchia. Whereas it doesn’t exist another alternative used in diagnostics and treatment of non-palpable testis, we consider it as a method of the first choice.

Key words:
cryptorchidism, laparoscopy, non-palpable testes, orchiopexy.

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