Treating non-palpable testes

  • For non-palpable testes, surgery must clearly determine whether a testis is present or not.
  • If a testis is found, the decision has to be made to remove it or bring it down to the scrotum.
  • Otherwise, the easiest and most accurate way to locate an intra-abdominal testis is through diagnostic laparoscopy
  • An important step in surgery is a thorough re-examination once the child is under general anesthesia, since a previously non-palpable testis might be identifiable and subsequently change the surgical approach to standard inguinal orchidopexy, as described above.

Nonpalpable Testis Laparoscopy

During a laparoscopy for non-palpable testes, possible anatomical findings include spermatic vessels entering the inguinal canal (40%), intra-abdominal testes (40%), peeping testes (10%), or blind-ending spermatic vessels confirming vanishing testis (10%).

In the case of a vanishing testis, the procedure is finished once blind-ending spermatic vessels are clearly identified.

If the vessels enter the inguinal canal, one may find an atrophic testis upon inguinal exploration or a healthy testis that needs to undergo standard orchidopexy.

A peeping testis can be placed down in the scrotum either laparoscopically or via an inguinal incision.

Cryptorchidism | 3. Master the treatment of cryptorchidism
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