Management of the impalpable testis: a six year review together with a national experience
E V Williams, T Appanna, M E Foster
Department of
Surgery, Royal Glamorgan Hospital, Llantrisant CF72 8XR, UK
Correspondence to: Mr Foster
Submitted 15
March 2000;
Accepted 20 September 2000
The management of undescended testes remains variable, and the
use of laparoscopy for localisation is controversial. This study
reviews the need for laparoscopy and also assesses the current practice
among a cohort of surgeons.
A retrospective review of all patients undergoing orchidopexy was
performed, together with a postal survey of all members of the Welsh
Surgical Society.
Of the 139 orchidopexies performed, the testis was deemed impalpable in
39 (28%) cases. All patients were treated with groin exploration, and
only in two (5%) patients was the testis not located. From the survey,
replies were received from 90 (81%) surgeons, of whom 65 (72%) were
still performing orchidopexy. Forty eight (74%) surgeons performed
orchidopexy between the age of 2 and 3, and only 32 (36%) performed
preoperative investigations. The follow up period was variable with the
majority of patients seen at six weeks.
Laparoscopy for the impalpable testis is not initially warranted. An
inguinal exploration is regarded as the definitive investigation. This
has the advantage of providing the diagnosis and treatment in the
majority of cases.
Keywords: cryptorchidism; impalpable testis; orchidopexy; laparoscopy
© 2001 by The Fellowship of Postgraduate Medicine
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