Laparoscopy in 100 consecutive patients with 128 impalpable testes

Cortes, Dina; Thorup, Jørgen; Lenz, Kristina; Beck, Bolette Daniels; Nielsen, Olaf

doi:10.1111/j.1464-410x.1995.tb07338.x

Cited by 56 publications

(36 citation statements)

References 25 publications

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“…The laparoscopic technique (Figure-1) has previously been described (4-6).The laparoscopic findings were similar to those described by Castilho in 1990 (7), and are summarized in Table- management was performed based on the laparoscopic findings (8,9). In cases of testicle absence , the procedure was interrupted, whereas in cases of intra-canalicular inguinal testis, open surgical exploration was performed.…”

Section: Methodsmentioning

confidence: 62%

Laparoscopic diagnosis and treatment of nonpalpable testis

et al. 2008

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Introduction: Treatment of the cryptorchid testicle is justified due to the increased risk of infertility and malignancy as well as the risk of testicular trauma and psychological stigma on patients and their parents. Approximately 20% of cryptorchid testicles are nonpalpable. In these cases, the videolaparoscopic technique is a useful alternative method for diagnosis and treatment. Materials and Methods:We present data concerning 90 patients submitted to diagnostic laparoscopy for impalpable testicles. Forty-six patients (51.1%) had intra-abdominal gonads. In 25 testicles of 19 patients, we performed a two stage laparoscopic Fowler-Stephens orchiopexy. The other 27 patients underwent primary laparoscopic orchiopexy, in a total of 29 testicles. Results: We obtained an overall 88% success rate with the 2 stage Fowler-Stephens approach and only 33% rate success using one stage Fowler-Stephens surgery with primary vascular ligature. There was no intraoperative complication in our group of patients. In the laparoscopic procedures, the cosmetic aspect is remarkably more favorable as compared to open surgeries. Hospital stay and convalescence were brief. Conclusions: In pediatric age group, the laparoscopic approach is safe and feasible. Furthermore, the laparoscopic orchiopexy presents excellent results in terms of diagnosis and therapy of the impalpable testis, which is why this technique has been routinely incorporated in our Department.

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Section: Methodsmentioning

confidence: 62%

Laparoscopic diagnosis and treatment of nonpalpable testis

et al. 2008

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“…Laparoscopy, while first used to evaluate non-palpable testes in 1976, has only become widely used in recent years. Traditionally, anorchia is diagnosed surgically when spermatic vessels and the vas enter a closed ring and no testicles are found after inguinal exploration or if spermatic vessels end blindly proximal to the inguinal ring (in which case no further exploration is deemed necessary) [21, 22]. However, exceptions have been described [23].…”

Section: Discussionmentioning

confidence: 99%

Lost and Found Testes: The Importance of the hCG Stimulation Test and Other Testicular Markers to Confirm a Surgical Declaration of Anorchia

McEachern¹,

Houle

Garel

et al. 2004

Horm Res Paediatr

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Background: In patients with impalpable testes,laparoscopy or open surgery is considered conclusive in establishing the absence of testicular tissue. Methods: Retrospective chart review. Results: Over a 22-year period, 4 out of 82 patients with a diagnosis of bilateral anorchia by laparoscopy or laparotomy had persistent testicular tissue suggested by endocrine evaluations. The clue to the presence of testicular tissue was: (1) a pubertal rise in plasma testosterone (2 patients); (2) the presence of possible Müllerian structures and of a detectable plasma anti-Müllerian hormone (1 patient), and (3) the fact that one of the gonads had not been seen at surgery (1 patient who still had a testosterone response to hCG postoperatively). Testes were localized by venography (3 patients) and laparotomy (1 patient). Conclusion: A surgical diagnosis of bilateral anorchia needs to be confirmed by hCG stimulation, gonadotropin levels, or other markers of testicular function.

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“…In accordance with this, CIS of the testis may be detected before puberty in boys with cryptorchidism [19, 22], in males with 45,X/46,XY mosaicism [6, 8], in individuals with androgen insensitivity [23, 24, 25], and in females with 46,XY gonadal dysgenesis [8, 23, 26]. However, testicular biopsy is not a sensitive method for detection of premalignant histological changes before adulthood [27, 28], and the diagnosis may be overlooked. In contrast, a testicular biopsy will detect CIS in almost all cases after puberty [29].…”

Section: Discussionmentioning

confidence: 99%

Management of Males with 45,X/46,XY Gonadal Dysgenesis

et al. 1999

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Males with the 45,X/46,XY karyotype and malformations of the external genitalia carry an increased risk of developing germ cell neoplasia of the gonads. We have studied gonadal tissue from 10 individuals, 0.3–17 years of age, with a male phenotype and either hypospadias and/or cryptorchidism. Four patients, 0.3–15 years of age, had carcinoma in situ, 1 boy had Sertoli-cell-only pattern and the remainder prepubertal histology. Gonadoblastoma or invasive carcinoma was not found. On the basis of our current knowledge we propose a strategy for management and follow-up of these boys in order to detect possible premalignant histological changes early and prevent development of a gonadal tumour.

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Laparoscopy in 100 consecutive patients with 128 impalpable testes

Cited by 56 publications

References 25 publications

Laparoscopic diagnosis and treatment of nonpalpable testis

Laparoscopic diagnosis and treatment of nonpalpable testis

Lost and Found Testes: The Importance of the hCG Stimulation Test and Other Testicular Markers to Confirm a Surgical Declaration of Anorchia

Management of Males with 45,X/46,XY Gonadal Dysgenesis

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