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Diagnostic Laparoscopy for the Management of Impalpable Testes

대한비뇨기과학회지 2011년 52권 5호 p.355 ~ 358
박지현 ( Park Ji-Hyun ) - Seoul National University College of Medicine Department of Urology

박용현 ( Park Yong-Hyun ) - Seoul National University College of Medicine Department of Urology
박관진 ( Park Kwan-Jin ) - Seoul National University College of Medicine Department of Urology
 ( Choi Hwang ) - Armed Foces Capital Hospital

Abstract


Purpose: Controversy exists regarding the best approach to impalpable testes. We determined the usefulness of diagnostic laparoscopy for the management of impalpable testes.

Materials and Methods: Between 2000 and 2008, 86 patients with a mean age of 34 months underwent diagnostic laparoscopy. An inguinal canal exploration was performed in all cases, except in patients in whom the internal spermatic vessels terminated intraperitoneally with a blind end.

Results:The undescended testis was right-sided in 24 patients (27.9%), left-sided in 47 patients (54.7%), and bilateral in 15 patients (17.4%). Three patients (3.5%) had bilateral impalpable testes. The vas and vessels traversed the internal ring in 51 of 89 impalpable testes (57.3%); 20 (22.5%) were localized intraperitoneally, and 18 (20.2%) were diagnosed as vanishing testes. Open orchiopexies were performed on 24 testes (27.0%) and orchiectomies were performed on 43 nubbin testes (48.3%). After a mean follow-up period of 30 months, 12 of the 14 testes (85.7%) were viable following open conventional orchiopexy, compared with 6 of the 10 testes (60%) following a 1-stage Fowler-Stephens orchiopexy.

Conslusions: Diagnostic laparoscopy is a very helpful and minimally invasive technique in the diagnosis of impalpable testes, especially when preoperative ultrasonography is not sufficiently informative.

키워드

Laparoscopy; Testis
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