Laparoscopic-Assisted Management of Impalpable Testis in Patients Older than 10 Years

Sangrasi, Ahmed Khan; Laghari, Abdul Aziz; Abbasi, Mujeeb Rehman; Bhatti, Salahuddin

doi:10.4293/108680810x12785289144449

Cited by 6 publications

(5 citation statements)

References 19 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This fact was also seen in our study where age group ranged between 13-34 years with the mean age of 20.75 + 5.98. Similar result was also seen by Sangrasi et 11,12 . But another study revealed 63% left sided testes 13 .…”

Section: Discussionsupporting

confidence: 90%

Laparoscopic –Assisted Orchidopaxy in Non-Palpable Testes in Adult Population

Mansoor

Arain

Choudary

et al. 2021

ashkmdc

View full text Add to dashboard Cite

ABSTRACT: Objectives: To present our experience of managing impalpable undescended testes in post-pubertal patients with intention of testicular preservation using laparoscopic assisted orchidopaxy. Study Design: Descriptive Case series. Place & Duration of Study: Department of Urology, Jinnah Postgraduate Medical Center (JPMC) Karachi, between Jan 2015 to Dec 2020 with minimal 6 months follow-up. Methodology: We included all patients with clinically impalpable testes with aged 12 and above. All patients had ultrasound abdomen performed as initial screening test followed by laparoscopic assessment and definite procedure. Patients with normal or hypo-plastic testes were underwent single staged orchidopaxy, while patients with testicular atrophy were planned for orchiectomy. Intraoperative testicular biopsy and Semen analysis were not routinely performed in our study. Results: Total 36 patients with 41 impalpable testes underwent laparoscopic localization and management. Mean age of patients was 20.75+ 5.98 years. 50% of testes were on the right side, 36.1% on left sided while 3.88% were bilateral. 5 (12.1%) patients had clinical inguinal hernia.. Diagnostic yield of ultrasound was (75.6%) and 100 % in laparoscopy. 33 testis were true intra-abdominal while 4 were inguinal and 4 were vanishing testes Normal looking testes were observed in 24 testes (64.86%) followed by hypoplastic in 11(29.72%) while 2 testes (5.40%) were atrophic. Two intra-operative complications included urinary bladder injury and vas deferens injury in one patient each. Postoperatively testicular ischemic necrosis in one (2.4%) and wound infection in 2 (4.8%) patients were noted. Late follow up revealed one port site hernia (2.4%) and one testicular atrophy (2.4%). Success rate of orchidopaxy in our study was 94.6%. Conclusions: Laparoscopic has been proved as excellent diagnostic and therapeutic tool for the management of intra- abdominal undescended testes in adolescent and post-pubertal patients. Key words: Impalpable testes, Laparoscopic-assisted orchidopaxy, Adolescent, Adult

show abstract

Section: Discussionsupporting

confidence: 90%

Laparoscopic –Assisted Orchidopaxy in Non-Palpable Testes in Adult Population

Mansoor

Arain

Choudary

et al. 2021

ashkmdc

View full text Add to dashboard Cite

show abstract

“…11 A similar mean age of 8.3±7.9 years was observed by David et al in boys with undescended testes in Nigeria 12 while Tseng et al reported it to be 9.2±1.2 years in Taiwan. 13 We observed that majority (77.9%) of the children had right while 15 15 Dar et al observed similar frequency of right and left undescended testes in Indian boys and reported it to be 79.0% and 21.0% respectively. 16 A comparable frequency of right (76.5%) and left (23.5%) undescended testes has been reported by Tseng et al in Taiwan.…”

Section: Discussionmentioning

confidence: 57%

Positive Predictive Value of MRI in the Diagnosis of Intra-Abdominal Undescended Testes Taking Laparoscopic Findings as Gold Standard

Jehangir¹,

Goraya²,

Qureshi³

2021

APMC

View full text Add to dashboard Cite

Background: Cryptorchidism also known as undescended testis, is a birth defect in male babies with higher frequency in preterm infants, leading infertility and other genital problems. In its treatment, diagnosis has a vital role. Objective: The objective of this study was to determine the positive predictive value of MRI in the diagnosis of intra-abdominal undescended testes taking laparoscopic findings as gold standard. Study Design: It was a cross-sectional survey. Settings: Research was conducted at Department of Diagnostic Radiology, Children Hospital & Institute of Child Health Lahore Pakistan. Duration: Six months from June 23, 2018 to December 22, 2018. Methodology: This study involved 68 boys aged between 2 to 15 years presenting with undescended testes. Intra-abdominal undescended testes were diagnosed on MRI and was later confirmed on laparoscopic findings which were taken as gold standard and diagnosis of MRI was judged accordingly as true positive or false positive. A written informed consent was obtained from parents of every patient. Results: The age of the children ranged from 2 years to 15 years with a mean of 8.1±3.5 years. Majority (n=53, 77.9%) of the children had right while 15 (22.1%) children had left undescended testes. Diagnosis of intra-abdominal testes was confirmed in 64 (94.1%) patients on laparoscopy. Thus, there were 64 true positive and 4 false positive cases. It yielded a positive predictive value of 94.1% for MRI in predicting intra-abdominal undescended testes taking laparoscopy as gold standard. Similar positive predictive value was noted across various age and anatomical side groups. Conclusion: The positive predictive value of MRI was found to be 94.1% in predicting intra-abdominal undescended testes taking laparoscopic findings as gold standard regardless of patient’s age and anatomical side which along with its non-invasive and radiation free nature advocates its preferred use in future practice.

show abstract

“…Even in adolescent and adult patients, laparoscopic orchidopexy is a safe and successful procedure for nonpalpable intra-abdominal UDT. [ 10 ]…”

Section: Discussionmentioning

confidence: 99%

“…Untreated cryptorchidism has deleterious effects on the testis over time, with the risk of malignancy in intra-abdominal testis as high as 5%, increasing with age. [ 9 10 11 12 ] Therefore, early investigations and treatment of impalpable testis are important to increase the likelihood of fertility and to allow early diagnosis of possible testicular malignancies.…”

Section: Introductionmentioning

confidence: 99%

Long-term Outcome of Laparoscopic Surgery for Nonpalpable Undescended Testis

Joshi,

Shah

2024

Journal of Indian Association of Pediatric Surgeons

View full text Add to dashboard Cite

Aims and Objectives: The aim of this study was to objectively assess the long-term results of laparoscopic orchidopexy in patients who were diagnosed clinically to have nonpalpable undescended testis (UDT). Materials and Methods: All operated cases of nonpalpable UDT from January, 2000, to January, 2014, were reviewed. After informed consent, all patients were subjected to a color Doppler ultrasound examination to assess the location of the testis, its size, blood supply, and consistency. The size of the testis, operated and nonoperated, was noted down in volume using the formula of 0.71 × length × breath × height. Results: A total of 114 patients could be identified, who had undergone laparoscopy for nonpalpable UDT in the study period. Of these, 44 patients (54 units) underwent a color Doppler study to assess the testes. All the testes were found to lie in the scrotum with preserved blood supply. The volume of the operated unilateral testes (mean = 1.605 cm3) was smaller than the normal nonoperated side (mean = 2.524 cm3). The smaller testicular volume was observed in spite of maintained blood supply to the testes. In cases of bilateral UDT, both the testes were smaller in size (mean = 2.2 cm3), but were comparable to each other. In addition, the ultrasound examination revealed the presence of normal homogenous parenchyma of all the testes similar to the nonoperated side. Conclusion: Laparoscopic orchidopexy is a safe and effective option in the treatment of nonpalpable UDT. On a long-term basis, it is possible to achieve scrotal position along with preserved blood flow following laparoscopic orchidopexy in all patients suffering from nonpalpable UDT.

show abstract

Laparoscopic-Assisted Management of Impalpable Testis in Patients Older than 10 Years

Abstract: Laparoscopic-assisted single-stage orchiopexy appears to be a safe, effective procedure for intraabdominal testis in adolescent and older patients.

Cited by 6 publications

References 19 publications

Laparoscopic –Assisted Orchidopaxy in Non-Palpable Testes in Adult Population

Laparoscopic –Assisted Orchidopaxy in Non-Palpable Testes in Adult Population

Positive Predictive Value of MRI in the Diagnosis of Intra-Abdominal Undescended Testes Taking Laparoscopic Findings as Gold Standard

Long-term Outcome of Laparoscopic Surgery for Nonpalpable Undescended Testis

Contact Info

Product

Resources

About