Abstract
A total of 123 children underwent inguinal explorations for nonpalpable testes. Unilateral absence of testis (monorchism) was encountered in 70 children. The left testis was absent in 80% and spermatic vessels with or without vas deferens were present in 76% of them. Fifty-three children (66 testes) had undescended testes. Thirty-eight testes were located intra-abdominally. Orchiopexy was performed to 48 testes, and 18 testes were removed. Techniques for preoperative localization of the nonpalpable testis include pelvic pneumography, inguinal herniography, gonadal venography, C.T.scanning and laparoscopy. But their use is considerably limited in children and is not recommended as a routine procedure. Absence of testis is proved by definitive indentification of blind-ending spermatic vessels at surgery. A bling-ending vas or epididymis does not have the same connotation. When the testis is found intra-abdominally and does not descend readily by conventional orchiopexy techniques, either testicular vessel transection (long loop vas orchiopexy) or staged orchiopexy can be chosen. The former technique must be decided early so that a wide peritoneal strip is left attached to the vas and the testis to preserve vasal blood supply. Orchiectomy is indicated in only carefully selected cases.
