INITIAL SCROTAL INCISION FOR UNILATERAL NONPALPABLE TESTIS
ABSTRACT
Purpose:
We investigated use of initial scrotal incision for the management of unilateral nonpalpable testis.
Materials and Methods:
Scrotal incision followed by laparoscopy was performed in a consecutive series of 40 boys with unilateral impalpable testis.
Results:
Initial scrotal incision revealed 22 scrotal nubbins and 4 extra-abdominal testes among the 40 patients. Of 13 patients with intra-abdominal testis 6 had a looping vas that was dissected to the internal ring via the scrotal incision, and the incision was used for orchiopexy in 12. Laparoscopy detected 1 case of intra-abdominal vanished testis but falsely diagnosed 6 additional cases based upon blind-ending vas and vessels despite a known scrotal nubbin. It also detected 13 intra-abdominal testes but was inconclusive in 14 cases in which vas and vessels exited the internal ring, not including the 4 patients with extra abdominal testes who did not undergo laparoscopy.
Conclusions:
Scrotal incision may be sufficient to diagnose testicular loss when a nubbin is encountered, and can detect an extra abdominal testis not palpated with the patient under anesthesia. The incision is used for orchiopexy in those patients with a testis that can be brought to the scrotum in a single stage. Laparoscopy potentially can be reserved for cases in which no nubbin is found and in all cases when a patent processus vaginalis is encountered.
From the Division of Pediatric Urology, Children's Medical Center and The University of Texas Southwestern Medical Center, Dallas, Texas
Correspondence: Division of Pediatric Urology, The University of Texas Southwestern Medical Center at Dallas, 6300 Harry Hines Blvd., Suite 1401, Dallas, Texas 75235 (telephone: 214-456-2481; FAX: 214-456-8803)
Papers Presented at Annual Meeting of the Section on Urology, American Academy of Pediatrics
ABSTRACT