Selective use of laparoscopy in nonpalpable undescended testes

• Published in: Urology annals Vol. 8; no. 1; pp. 81 - 83
• Main Authors: Jamalalail, Yasser, Guerra, Luis, Leonard, Michael
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow Publications 01-01-2016; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Abdomen; Care and treatment; Children; cryptorchidism; diagnosis; Health aspects; Laparoscopy; Localization; Medical research; Methods; Original; Patient outcomes; Pediatrics; Precision medicine; Studies; Ultrasonic imaging; ultrasound; Undescended testes; undescended testis; diagnosis; Children; undescended testis; cryptorchidism; ultrasound
• ISSN: 0974-7796; 0974-7834
• DOI: 10.4103/0974-7796.171498

Introduction: 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 1st: 7; 3rd: 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.
Conclusion: 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.