Impalpable Testis: Evaluation of Diagnostic and Treatment Procedures and Our Treatment Protocol

Ivana Fratrić, Dragan Šarac, Jelena Antić, Marina Đermanov, Radoica Jokić, Ivana Fratrić, Dragan Šarac, Jelena Antić, Marina Đermanov, Radoica Jokić

Abstract

Introduction: The aim of this study is to present our treatment protocol for impalpable testis.

Material and methods: In a retrospective study we analyzed clinical data including diagnostic procedures, intraoperative findings, final diagnosis, treatment modality, and outcome of patients with impalpable testis who underwent surgery from January 2010 until December 2015.

Results: Ninety-one patients were admitted under the diagnosis of impalpable testis. In 39 patients ultrasound detected testis in the inguinal canal and orchidopexy was done. In 25 patients (48.08%) laparoscopy showed the entrance of the spermatic cord into the inguinal canal. Open exploration of the inguinal canal was done, testicular remnant removed, and appropriate testicular prosthesis implanted. Twenty patients (20/52) underwent orchidopexy of the abdominal testis (46.51%), 4 of which underwent Fowler-Stevens procedure in two stages, and in 16 patients deliberation of the testis and spermatic cord was sufficient to place the testis into the scrotum.

Conclusions: Excision of the testicular nubbin is highly recommendable, as well as implantation of the testicular prosthesis at the time of orchiectomy.

Figures

Figure 1
Figure 1
Laparoscopic approach showing both intra-abdominal testes proximal to the internal inguinal ring. The straight arrow is the testis and the dotted arrow is the internal inguinal ring.
Figure 2
Figure 2
Implantation of the testicular prosthesis.
Figure 3
Figure 3
Treatment protocol.

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Source: PubMed

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