Diagnostic Laparoscopy for the Management of Impalpable Testes
박지현, 박용현, 박관진, Choi Hwang,
소속 상세정보
박지현 ( Park Ji-Hyun )
Seoul National University College of Medicine Department of Urology
박용현 ( Park Yong-Hyun )
Seoul National University College of Medicine Department of Urology
박관진 ( Park Kwan-Jin )
Seoul National University College of Medicine Department of Urology
( Choi Hwang )
Armed Foces Capital Hospital
KMID : 0358320110520050355
Abstract
Purpose: Controversy exists regarding the best approach to impalpable testes. We determined the usefulness of diagnostic laparoscopy for the management of impalpable testes.
Materials and Methods: Between 2000 and 2008, 86 patients with a mean age of 34 months underwent diagnostic laparoscopy. An inguinal canal exploration was performed in all cases, except in patients in whom the internal spermatic vessels terminated intraperitoneally with a blind end.
Results:The undescended testis was right-sided in 24 patients (27.9%), left-sided in 47 patients (54.7%), and bilateral in 15 patients (17.4%). Three patients (3.5%) had bilateral impalpable testes. The vas and vessels traversed the internal ring in 51 of 89 impalpable testes (57.3%); 20 (22.5%) were localized intraperitoneally, and 18 (20.2%) were diagnosed as vanishing testes. Open orchiopexies were performed on 24 testes (27.0%) and orchiectomies were performed on 43 nubbin testes (48.3%). After a mean follow-up period of 30 months, 12 of the 14 testes (85.7%) were viable following open conventional orchiopexy, compared with 6 of the 10 testes (60%) following a 1-stage Fowler-Stephens orchiopexy.
Conslusions: Diagnostic laparoscopy is a very helpful and minimally invasive technique in the diagnosis of impalpable testes, especially when preoperative ultrasonography is not sufficiently informative.
키워드
Laparoscopy; Testis
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