EVALUATION OF THE ROLE OF LAPAROSCOPY IN MANAGEMENT OF THE NONPALPABLE TESTIS

Aim: To evaluate the safety, efficacy of the laparoscopic treatment of nonpalpable testes (NPT) and follow up the results for 12 months after orchiopexy. 
Methods: Between June 2004 and June 2007, 40 nonpalpable testes in 35 patients were evaluated by laparoscopy. Patients age ranged from 2 years to 22 years (mean age 8±4 y). The laparoscopy was used in all cases under general anesthesia. 
Results: Laparoscopic diagnosis was successful in 32 of 35 cases (91.4%) and 36 of 40 NPT (90%). Laparoscopic orchiopexy was successful in treatment of 12 testes (30%) and laparoscopic orchiectomy was successfully done in 9 testes (22.5%). The reasons for orchiectomy included dysgenesis in 2 cases, atrophic remnants in 4 cases and ischemia after Fowler-Stephens in 3 cases. While the standard orchiopexy was done in 13 testes (32.5%) and standard orchidectomy was done in 2 testes (5%) due to canalicular vanishing testes. The mean laparoscopic operative time was 62 ± 14.3 minutes. The mean hospital stay was 1.8 ± 0.6 days. The mean length of follow up was 12 + 4.3 months. The testes were located in the scrotum in all orchiopexies. 
Conclusion: laparoscopy is the diagnostic modality of choice for evaluating the nonpalpable testis because it is reliable and safe in locating the testis or in proving its absence. Laparoscopic orchiopexy is feasible.