[ role of laparoscopy for management of nonpalpable testis [NPT]]

ABSTRACT

Undescended testes is seen in 3.4% male neonates and 20% of these testes are nonpalpable. This study was done to evaluate the diagnositic and therapeutic effects of laparoscopy in children and young adults nonpapable testes. This descriptive study was done in Urology Department of Ghaem Hospital. 15 patients aged 9 months to 31 years and 19 Testes were studied. Through a 5 or 10 mm incision above umbilicus, 5 or 10 mm Hasson trocar was inserted under vision. 5 or 10 mm telescope was used to see whether the testis was present or not. If not, the operation was ended. Otherwise, the process followed by standard orchidopexy or laparoscopic orchidopexy or laparoscopic orchidectomy. 2 cases did not have testis [19 and 3 years], 9 cases had unilateral NPT [7 rights, 2 left]; three bilateral, and the last one, a case of testicular feminization with karyotype of 46 XY and cheif complaint of amenorrhea. 4 cases had standard orchidopexy and in the last three, one stage laparoscopic orchidopexy was done. In the testicular feminization case laparoscopic orchidectomy. All testes brought into the subdartus fascia, they remaind in the scrotume without athrophy. Laparoscopy is the best tool for diagnosis of non palpable testis. Laparoscopic orchidectomy is also the choice treatment for testicular feminization. Laparoscopic orchidopexy is feasible and can be a duplicate of open orchidopexy