Abstract
Purpose: To evaluate our strategy for treating nonpalpable testis (NPT) over 10 years. Methods: Between 1993 and 2002, we treated 214 testes in 170 patients treated in our institutions. Of those, 33 NPT in 31 patients were reviewed with regard to the surgical approach, location of testis, pathological findings, and outcomes. Results: In patients with NPT, primary inguinal exploration with follow up by laparoscopy is the first choice of procedure. If neither vas nor vessel was detected, laparoscopic examination was done. Primary inguinal exploration was performed for 30 NPT testes in 28 patients. Eleven testes (36.7%) were found in the inguinal canal and orchiopexy was performed. In 17 cases (56.7%) , atrophic testis or vanishing testis was found in the inguinal canal and orchiectomy was performed. In 2 testes (6.7%) , the vessel was not found in the inguinal canal and laparoscopic examination confirmed absent testis. Conclusion: The majority of NPTs were located in the inguinal canal and more than half were atrophic or vanishing testis. In one third, orchiopexy was possible through the inguino-scrotal approach. As the number of NPT requiring laparoscopic examination is very small, primary inguinal exploration is the treatment of choice for managing NPT.
