Nonpalpable testes: Ultrasound and contralateral testicular hypertrophy predict the surgical access, avoiding unnecessary laparoscopy

Inguinal US of non-palpable testes and measurement of the contralateral testis are synergistic in predicting the surgical approach. The addition of ultrasound to a clinical exam, performed also under general anesthesia and by an experienced pediatric urologist significantly increases the prediction of the correct surgical approach. Our results translate into five boys needing an US of the NPT to prevent one laparoscopy. Whereas cost-effectiveness of US might be debatable in regard to different healthcare systems, it is proven to be an effective, non-harmful tool to avoid unnecessary diagnostic laparoscopies.718Figure.. Performance of the combination of clinical parameters versus added ultrasound to correctly predict inguinal incision or laparoscopy. True pos: correctly predicted inguinal incision. True neg: correctly predicted laparoscopy. False pos: predicted inguinal incision, when laparoscopy was appropriate. False neg: predicted laparoscopy, when inguinal approach was appropriate.