Additional Benefit of Laparoscopy for Nonpalpable Testes: Finding A Contralateral Patent Processus

Önal, Bülent; Kogan, Barry A.

doi:10.1016/j.urology.2007.11.157

Cited by 8 publications

(4 citation statements)

References 21 publications

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“…Many authors have published their cumulative experience about LO for palpable and non-palpable UDT ( 17 – 19 ). LO has obvious superiorities such as sufficient retroperitoneal dissection, sufficient testes mobilization and bilateral investigation, as well as easy fixation of the unclosed internal ring.…”

Section: Discussionmentioning

confidence: 99%

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Cai

et al. 2018

Front. Pediatr.

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Purpose: To assess the outcomes of a novel laparoscopic assisted transcrotal orchidopexy (LATO) combined with percutaneous extraperitoneal closure (PEC) for palpable inguinal canalicular cryptorchidism accompany with indirect inguinal hernia, and evaluate its safety and efficiency.Materials and Methods: A retrospective cohort study for single-port LATO-PEC and traditional inguinal orchidopexy (TIO) was performed between 2011 and 2014. Totally 53 children with both palpable inguinal canalicular testes and indirect inguinal hernia were included. Median patient age was 15month (range, 6 months to 4 years). Of them, 35 patients underwent LATO-PEC procedure, utilizing an umbilical trocar for laparoscope, transcrotal dissection for orchidopexy, and an inner two-hooked cannula for ligation of the patent processus at the level of the internal ring. Three of them were bilateral, 12 on the left side and 20 on the right. Eighteen patients received TIO, seven of them on the left side and 11 on the right. Patient demographics, surgical technique, complications, and clinical outcomes were reviewed. Follow-up visits were performed to reassess position and size of the testes.Results: All 56 undescended testes were delivered into the scrotum successfully. In the LATO-PEC group, nine contralateral herniorrhaphy were accomplished simultaneously. Fifteen contralateral patent processus vaginalis (PPVs) in 32 unilateral undescended testis (UDT) were newly confirmed during the laparoscopy, while 6 of them received percutaneous extra-peritoneal herniorrhaphy for visible inguinal bubble in pneumoperitoneum condition. No additional port placement or conversion to open procedure was needed. Mean operative time for unilateral and bilateral LATO-PEC in this study was (37.81 ± 5.23) min and (53.33 ± 2.98) min, respectively. In TIO group, mean operative time was (41.11 ± 8.67) min. There was no statistical difference in operative time between the two approaches for unilateral UDTs (p = 0.098). Median follow-up interval was 24 months (range, 12–84 months). No operative complications were found in either group to date.Conclusions: Singe-port LATO-PEC is a safe, effective, and cosmetic choice for inguinal canalicular cryptorchidism accompany with indirect inguinal hernia, minimizing injuries to the vas deferens and testicular vessels. Laparoscopy can provide a diagnostic and therapeutic solution of contralateral PPV.

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Section: Discussionmentioning

confidence: 99%

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Cai

et al. 2018

Front. Pediatr.

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“…For the contralateral PPV, our study showed an incidence of 16.4% and no remarkable relationship with age, which was consistent with a previous study. 10 Other consistent results included most patients younger than 2 years old, a majority of atrophic or absent testes, and no significance in side. However, some remarkably different results also existed.…”

Section: Discussionmentioning

confidence: 77%

“…Only a few researchers have specifically concentrated on the incidence of PPV detected during laparoscopy. 10 Although a few reports have noted that laparoscopy is beneficial for detecting and handling PPV in patients with a nonpalpable testis, as far as we know, few studies have investigated the incidences of both ipsilateral and contralateral PPV and explored the associated factors. 11 …”

Section: Introductionmentioning

confidence: 99%

Ipsilateral and contralateral patent processus vaginalis in pediatric patients with a unilateral nonpalpable testis

Xie

Huang

et al. 2023

Asian Journal of Andrology

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This study aimed to investigate the incidence of patent processus vaginalis (PPV) in pediatric patients with a unilateral nonpalpable testis and explore the associated factors. From May 2014 to April 2017, 152 boys who were diagnosed with a unilateral nonpalpable testis and underwent laparoscopy in Shanghai Children’s Hospital (Shanghai, China) were included in this study. The data were collected and reviewed, and the results were analyzed regarding the age at operation, side, development, and position of the nonpalpable testis. The mean age of the patients was 2.6 (standard deviation: 2.3) years. The testis was absent in 14 cases, nonviable in 81 cases, and viable in 57 cases. The incidence of PPV was 37.5% (57 of 152) on the ipsilateral side and 16.4% (25 of 152) on the contralateral side. The ipsilateral PPV was more prevalent when the nonpalpable testis occurred on the right side (P < 0.01). Besides, patients with a viable testis had a greater incidence of ipsilateral PPV than those with a nonviable or absent testis (P < 0.01). Moreover, this rate was the highest when the testis was in the abdominal cavity and the lowest when the testis was in the scrotum (both P < 0.01). However, the incidence of contralateral PPV was independent of all the factors. In conclusion, in children with a nonpalpable testis, the incidence of an ipsilateral PPV was significantly related to the side, development, and position of the testis, while it was independent of these factors on the contralateral side.

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“…Another study by Khalid Ismail et al 28 found the overall diagnostic agreement of ultrasonography with laparoscopy was 21.3%. In another series conducted by Onal 29 have found that the incidence of a contralateral patent process vaginalis is considerable in patients presenting with a unilateral nonpalpable testis and this can be easily recognized during laparoscopy, which is an additional benefit of using laparoscopy. One study conducted by Hay SA et al, 30 has done laparoscopic classification of testis to facilitate decision making during the laparoscopy, according to the position of the impalpable testis and in the relation of the spermatic vessels and vas deferens to the internal ring, with a management protocol based on this classification.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Management of Impalpable Testis in the Era of Laparoscopy

Shaikh¹

2010

WJOLS

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Additional Benefit of Laparoscopy for Nonpalpable Testes: Finding A Contralateral Patent Processus

Cited by 8 publications

References 21 publications

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Ipsilateral and contralateral patent processus vaginalis in pediatric patients with a unilateral nonpalpable testis

Diagnostic and Therapeutic Management of Impalpable Testis in the Era of Laparoscopy

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