Laparoscopic orchiectomy for the adult impalpable testis – experiences in a rural teaching hospital

Abstract

Laparoscopic orchiectomy seems to be advantageous and well received by patients. We preferred the laparoscopic approach for the obvious benefits of less pain, better cosmesis, and early discharge.

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

“…This is because in the Western world patients are identified and treated in childhood due to good health care systems and awareness of the problem. In developing countries, late presentation of undescended testis is not uncommon; however, with the introduction and increasing use of laparoscopy in the third world, a few studies have been done in India for management of impalpable testis in adults 20,21 with satisfactory results inconsistent with the results of this study. In our study, patients were comparatively older compared with patients in other international studies, because of the late presentation of patients in this part of world.…”

Testicular sperm extraction after laparoscopic orchiectomy for bilateral postpubertal intra-abdominal cryptorchidism: What chance of sperm retrieval?

“…In the developed world, it is rare to see a patient with undescended bilateral testis presenting in adulthood. The reasons for this are multifactorial, but the main are the lack of sexual education among the general population and poor access to healthcare facilities (Rangarajan & Jayakar, ). Indeed, only few studies investigated the management of older patients with cryptorchidism and their risk to progress a testicular cancer, because patients in the Western word are generally identified and treated in childhood, due to good attentiveness of the problem (Singh, Bajaj, Kaur, Mishra, & Riar, ).…”

“…Indeed, only few studies investigated the management of older patients with cryptorchidism and their risk to progress a testicular cancer, because patients in the Western word are generally identified and treated in childhood, due to good attentiveness of the problem (Singh, Bajaj, Kaur, Mishra, & Riar, ). The treatment of cryptorchidism in postpuberal age remains controversial (Desai, Prabhu, & Supe, ; Rangarajan & Jayakar, ). The possible therapeutic options are orchiectomy, orchidopexy and close observation.…”

“…For this reason, orchiectomy is indicated in our patient, although the histologic analyses did not reveal neoplastic cells. In particular, in cases of intra‐abdominal testicle, in addition to the possibility of cancer, it must be added the risk of testicular torsion (Rangarajan & Jayakar, ). Furthermore, also in case of unilateral cryptorchidism, there is an increased risk of cancer in the contralateral normally descended testicle.…”

Laparoscopic orchidopexy with transabdominal preperitoneal hernia repair in an adult

“…To date, there have been only eight reports of laparoscopic surgery for cryptorchidism with inguinal hernia repair. Two reports presented with totally extraperitoneal repair , and six described laparoscopic surgery with TAPP hernia repair ; all cases were done with orchiectomy. Simultaneous orchiectomy is recommended for postpubertal patients because of the risk of malignancy.…”