Diagnostic laparoscopy and management of the impalpable testis – a review of 10 years' practice at a non-paediatric specialist centre

BackgroundLaparoscopy is used for the diagnosis and treatment of impalpable testes. We reviewed practice and outcomes in our unit over the last 10 years.MethodsRetrospective case-note review of patients undergoing laparoscopy with or without orchidopexy for impalpable testes.ResultsEighty-three patients underwent laparoscopy. Twelve patients had bilateral impalpable testes; 25.3% of testes were identified intra-abdominally, 21% in the internal ring, and 29.5% of cases had vas and vessels entering the deep ring. A 76.5% success rate was achieved following diagnostic laparoscopy and standard open orchidopexy for testes in the region of the internal ring, compared to a 40.0% success rate following one-stage laparoscopic orchidopexy for ‘low’ intra-abdominal testes.ConclusionLaparoscopy is useful in managing patients with an impalpable testis from both a diagnostic and therapeutic standpoint. The success rate following laparoscopic orchidopexy in our non-paediatric specialist centre is lower than in most reports from paediatric specialist centres. This suggests the importance of centralization of such complicated, less frequently performed surgical procedures to a specialist centre.