2009, Number 5
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Rev Mex Urol 2009; 69 (5)
Laparoscopic orchidopexy in palpable and nonpalpable undescended testis
Riquelme-Heras MA, Landa-Juárez S, Miguel-Gómez D, Meneses-Juárez H, Andraca-Dumit R
Language: Spanish
References: 16
Page: 215-218
PDF size: 2035.50 Kb.
ABSTRACT
Background: Undescended testis should be identified at birth. Inappropriate treatment of complications can be serious, so its evaluation and specialized approach are a priority. Classification in relation to gonadal height provides a general idea of prognosis. Best age for management is still controversial. The conventional approach continues to be open orchidopexy. However, laparoscopy has been gaining ground.
Objective: To evaluate a group of patients presenting with this anomaly who were treated laparoscopically.
Materials and methods: A total of 27 patients with palpable or nonpalpable undescended testes who underwent laparoscopic orchidopexy between January 2002 and September 2003 were evaluated.
Results: Thirty testicular units were brought into the scrotum by means of laparoscopic approach: 13 right testes, 6 left, 3 bilateral, 19 palpable testes and 11 nonpalpable testes. Mean age of the patients was 21.5 months. There was only one case of testicular atrophy. Orchidopexy was achieved in 100% of patients and all but two patients were released 24 hours after surgery.
Conclusions: Laparoscopic orchidopexy for undescended testis management has grown in popularity and is becoming more reproducible and useful in relation to opportune diagnosis and treatment.
REFERENCES
Berkowitz GS, Lapinski RH, Dolgin SE, Gazella JG, Bodian CA, Holzman IR. Prevalence and natural history of cryptorchidism. Pediatrics 1993;92(1):44-9.
Kogan SJ. Fertility in cryptorchidism. An overview in 1987. Eur J Pediatr 1987;146 (supply 2):S21-4.
Schultz KE, Walker J. Testicular torsion in undescended testes. Ann Emerg Med 1984; 13(4):567-9.
McAleer IM, Packer MG, Kaplan GW, Scherz HC, Krous HF, Billman GF. Fertility index analysis in cryptorchidism. J Urol 1995; 153(4):1255-8.
Swerdlow AJ, Higgins CD, Pike MC. Risk of testicular cancer in cohort of boys with cryptorchidism. BMJ 1997;314(7093):1507-11. [Published erratum appears in BMJ 1997; 315:1129].
Cisek LJ, Peters CA, Atala A, Bauer SB, Diamond DA, Retik AB. Current findings in diagnostic laparoscopic evaluation of the nonpalpable testis. J Urol 1998;160(3 pt 2):1145-9.
Koop CE. Technique of herniorraphy and orchiopexy. Birth Defects Orig Artic Ser 1977; 13(5):293-303.
Docimo SG. The results of surgical therapy for cryptorchidism: a literature review and analysis. J Urol 1995;154(3):1148-52.
Kiesewetter WB, Mammen K Kalyglou M. The rationale and results in two stages orchiopexies. J Pediatric Surg 1981;16(4 suppl):631-5.
Bloom DA. Two-step orchiopexy with pelviscopic clip ligation of spermatic vessels. J Urol 1991;145(5):1030-33.
Silber SJ. Microsurgery for the undescended testicle. Urol Clin North Am 1982; 9(3):429-38.
Poppas DP, Lemark GE, Minimberg DT. Laparoscopic orchiopexy: clinical experience and description of technique. J Urol 1996;155(2) 708-11.
Lindgren BW, Darby EC, Faiella L, Brock WA, Reda EF. Laparoscopic orchiopexy; Procedure of choice for the no palpable testis? J Urol 1998;159(6) 2132-5.
Docimo SG, Moore RG, Adams J, Kavoussi LR. Laparoscopic orchiopexy for the high palpable undescended testis: preliminary experience. J Urol 1995;154(4):1513-5.
Ferro F. The Nonpalpable Testis. In: Endoscopic Surgery in Children, 1st ed. 1999. Edited by NMA Bax, KE Georgeson, A Najmaldin, JS Valla. Verlag-Berlin- Heidelberg: Springer, p. 393-407.
Hutson JM. Undescended testis, torsion, and varicocele. In: Pediatric Surgery, 5th ed. 1998. Edited by JA O’Neill Jr., MI Rowe, JL Grosfeld, EW Fonkalsrud, AG Coran. St. Louis Missouri: Mosby-Year Book, p. 1087-1109.