Groin exploration for the nonpalpable testes: A single center experience

Abstract

Background:Management of non-palpable testes in Nigeria can be difficult due to late presentation and poor resources. Surgical exploration is often required for diagnosis and treatment.Aim:This study reviews the management outcome of clinically non-palpable testeis in a tertiary center in Nigeria.Materials and Methods:Ten years retrospective review of all clinically non-palpable testes in children aged 2–15years managed at the Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria.Results:Thirty two children with 44 testicular units were managed. The right side was involved in 12 (37.5%); left in 8 (25.0%) and bilateral in 12 (37.5%) patients. Pre-operative ultrasound was done in 12 patients with localization in just 4 patients (33.3% success rate). At groin exploration, 34 (77.32%) testicular units were located in the inguinal canal. Eight patients with 10 The remaining 10 (22.7%) testicular units required additional mini-laparotomy for which six (13.6%) and 4 (9.1%) testicular units respectively were either in the retroperitoneum or not found. Of the testes in the groin, twenty two (64.7%) testicular units were normal while 12 (35.3%) were atrophic. Four of the retroperitoneal testes were normal while 2 were atrophic. Eight (22.5%) testicular units among the inguinal group had multi-staged orchidopexy; while 2 each of the retroperitoneal group had orchidectomy, one stage orchidopexy, two staged Fowler Stephens (F-S) procedure or lost to follow up after first stage of F-S procedure. Mean follow up period was 2 months. 2 testicular units each had retracted or vanished respectively during follow up.Conclusion:Groin exploration still offers a viable approach Surgical exploration is still useful in to the management of non-palpable testes in low resource environment despite the lack of laparoscopy.

A collective review of cases with cryptorchidism managed in a teaching hospital in Sudan

“…In this study, 16 patients (53.3%) had associated malformations, of them 13 (43.3% of the total group of 30) had associated hernia sacs. In a study from Nigeria associated hernia sacs were found in 52% (Sowande et al 2015).…”

“…Another study from Nigeria reported correction of UDT in 52.2% of patients after five years and in 26.9% who presented as adults (Adeoti et al 2004). A recent study from Ireland reported that only 29% of patients with UDT proceeded to surgery before two years, and the mean age at orchidopexy was 5.6 years (Sowande et al 2015). In contrast, a study from the USA reported that the median age at consultation and surgery was 20.3 and 28.9 months, respectively (Mlay & Sayi 1994).…”