Laproscopic orchiopexy for the nonpalpable testis: 3 years experience

Abstract

Background: We evaluated the safety and efficacy of laparoscopic orchiopexy in management of nonpalpable intra-abdominal testis and studied the outcomes. Here, 3 years' experience is being reported. Methods: Laparoscopic Orchiopexy was performed on 28 children (32 testicular units) for non-palpable intra-abdominal testis between 2010 and 2012. We retrospectively reviewed the medical records. The mean age was 3.4 years (range, 2.5-11 years). Of the 28 patients, 18 (64.3 %) were on the right, 6 (21.4%) were on the left and 4 (14.3%) were bilateral. The mean follow-up period was 14.8 months (range, 3-36 months). Testicular viability and orchiopexed positioning were evaluated within 1 month and beyond 3 months. Results: Thirty one testes were descended successfully by laparoscopy. The average operative time was 41.5 ± 3.8 min. Primary laparoscopic orchiopexy done in 26 testes. Three of unilateral and 2 of bilateral testicular units underwent one-stage Fowler-Stephens Orchiopexy. One patient needed laparoscopic orchiectomy. At follow-up (mean 14.8 months), one testis atrophied and needed orchiectomy. Testicular survival rate was 96.8% (30/31) and all of the testes maintained an adequate size. Twenty six (83.9%, 26/31) are in an acceptable scrotal position and 4 testes (12.9%, 4/31) are mid to high in the scrotum without atrophy. There was no recurrent inguinal hernia. Conclusions: Laparoscopic orchiopexy is successful for a nonpalpable intra-abdominal testis with a high testicular survival rate. The low incidence of complications and high success rate underscore the feasibility of this procedure.