Treatment of impalpable testis – one clinic’s experience
| Autor: | Paweł Osemlak, Tomasz Żądkowski, Błażej Rogowski, Czesław Cielecki, Andrzej Wieczorek, Magdalena Woźniak, Grzegorz Jędrzejewski, Iwona Beń-Skowronek, Paweł Nachulewicz |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | Videosurgery and Other Miniinvasive Techniques, Vol 12, Iss 2, Pp 166-171 (2017) |
| Druh dokumentu: | article |
| ISSN: | 1895-4588 2299-0054 |
| DOI: | 10.5114/wiitm.2017.67482 |
| Popis: | Introduction : Undescended testes are recognised in 1% to 2% of boys during the first year of life, and about 20% of them are impalpable. Ultrasonography (US) may establish the localisation of the testis but the final diagnosis is usually determined laparoscopically. Aim : To evaluate long-term results of laparoscopic treatment of boys with impalpable testes and sensitivity of preoperative ultrasound. Material and methods : Between 2011 and 2015, we operated on 545 boys with undescended testes. Sixty-two of them with 65 impalpable testes were treated laparoscopically – the study group. Mean age was 3.5 years. The study group was divided into 5 groups according to type of treatment. The volume and position of the operated gonad were assessed manually and by ultrasound. Results : In group 1 testicular agenesis was observed in 19 patients. In group 2 revision of the inguinal canal revealed testicular agenesis in 7 and atrophy in 4 patients. In group 3 conversion to classic orchiopexy was performed in 10 patients. In group 4 one-stage orchiopexy was performed in 9 patients on 12 testes. In group 5 a two-stage F-S procedure was performed in 13 patients. Ten testes in group 4 had a volume in the normal range (84%) and also 10 testes in group 5 (77%). Conclusions : Laparoscopy in impalpable testes is the procedure of choice and allows definitive management, even when conversion to open procedure is necessary. Sensitivity of preoperative ultrasound is generally about 60% for true intra-abdominal testes, so diagnostic laparoscopy is necessary. |
| Databáze: | Directory of Open Access Journals |
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