Publications of Faculty of Medicine:Feasibility and Outcome of Laparoscopic Management of Impalpable Testis: Abstract

Feasibility and Outcome of Laparoscopic Management of Impalpable Testis
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The study aimed to evaluate the diagnostic yield of exploratory laparoscopy (EL) and the feasibility of therapeutic laparoscopy and its outcome for management of impalpable testis (IT). The study included 23 patients; 7 patients had bilateral and 16 patients had unilateral ff and 5 of them had previous negative groin exploration. After full clinical examination and ultrasonographic examination, all patients had (EL) followed by one-stage or two-stage Fowler-Stephens (FS) procedure for orchidopexy according to exploratory findings. (EL) was conducted successfully in all patients with a mean duration of 23.2+2.5 minutes and a mean total operative time of 90.6111.8 minutes. (EL) defined 3 vanished testes (10%), 2 small testicular remnant and one grossly dysmorphic intra-abdominal testicle. Two-stage procedure was applied for 9 testicles, but one testicle was non-viable on the second- stage laparoscopy and orchidectomy was performed with a failure rate of 11.1%. Successful orchidopexy was achieved in 23 testicles and orchidectomy was conducted for 4 testicles (13.3%). Throughout follow-up period only 3 testicles (13%) were high up in the neck of the scrotum but no testicle retracted to be intracanalicular. Nineteen testicles showed progressive increase in size approaching the size of normal age-cross matched boys, 3 testicles were stationary while one testicle decreased in size compared to its immediate postoperative size. Conclusion, laparoscopic management of (17) could be considered as a safe and effective surgical option irrespective of its location and could spare subsequent inguinal exploration in 16.7% with a final success rate of 137%. Two-stage (FS) procedure provided good results for (17) with short vessels and appropriate vas length with a second stage failure rate of 11.1%. Keywords: impalpable testis, Laparoscopy, Fowler-Stephens procedure