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J Urol. 2004 Oct;172(4 Pt 2):1742-5; discussion 1745.

Initial scrotal incision for unilateral nonpalpable testis.

Author information

1
Division of Pediatric Urology, Children's Medical Center and The University of Texas Southwestern Medical Center, Dallas, Texas 75235, USA. warren.snodgrass@childrens.com

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.

PMID:
15371803
[Indexed for MEDLINE]

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