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KMID : 1218220090010010051
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Korean Journal of Pediatric Urology
2009 Volume.1 No. 1 p.51 ~ p.57
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The Fate of Nonpalpable Testis according to the Status and Management of Testis
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Chung Kyung-Jin
Jung Byung-Joo
Park Seo-Yong
Park Kwan-Hyun
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Abstract
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Purpose: To evaluate the viability and location of the nonpalpable testis (NPT) and to analyze the surgical success rate after orchiopexy, we retrospectively reviewed the medical records.
Patients and Methods: From January 1996 to May 2006, 105 patients (121 testes) were included. Mean age was 2.8 years and mean follow up period was 23.1 months. After meticulous physical examination, all the patients with NPT were evaluated the status of the testis under diagnostic laparoscopy. Then, orchiopexy for viable testis, nubbinectomy for testicular nubbin, or interruption of further procedure for vanishing or agenesis was chosen. We evaluated the surgical success rate after orchiopexy.
Results: Out of 121 testes, 52 (43.0%) were viable, 54 (44.6%) were nubbin and 15 (12.4%) were vanishing. The rate of viable testis in bilateral cases was 84.4% (27/32), which was significantly higher than 28.1% (25/89) in unilateral cases (p＜0.001). The surgical success rates were 90% (27/30) in inguinal orchiopexy group, 100% (7/7) in laparoscopic orchiopexy group and 75% (6/8) in Fowler-Stephens orchiopexy group. There was no significant difference in the success rate among the three groups. Also, age, location and laterality of the viable testis did not influence the surgical success rate significantly.
Conclusions: We should expect relatively higher possibility of viable testis in bilateral NPT than unilateral cases, and thus need to prepare orchiopexy more actively in bilateral NPT cases. The success rate after orchiopexy was 88.9% (40/45), which was quite high and comparable with the previous reports. The patient’s age, methods of orchiopexy, and the location or laterality of the NPT did not influence the surgical success rate.
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KEYWORD
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Laparoscopy, Surgery, Undescended testis
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