Laparoscopic evaluation and treatment of the impalpable testis

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dc.contributor.authorDénes, F. T.
dc.contributor.authorSilva, F. A Q
dc.contributor.authorGirón, A. M.
dc.contributor.authorArap, S.
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2014-05-27T11:20:14Z
dc.date.available2014-05-27T11:20:14Z
dc.date.issued2001-01-01
dc.description.abstractObjectives: To evaluate the laparoscopic technique as a diagnostic and therapeutic tool in the management of patients with impalpable testis. Material and Methods: Fifty-nine patients with mean age of 6.3 years underwent laparoscopy to evaluate 85 impalpable testes that were classified as absent, canalicular and intra-abdominal. In the case of testicular absence, the procedure was terminated. In the case of canalicular testis, open inguinal exploration was performed. In intra-abdominal testis, either laparoscopic orchiopexy or orchiectomy was performed. According to the length of the vascular pedicle, orchipexy was performed either with or without vascular ligature. Post-operatively, the treated testes were evaluated according to size and location in the scrotum. Results: Seventeen (20%) of the 85 impalpable testes were diagnosed as absent, 21 (24.7%) as canalicular and 47 (55.3%) as intra-abdominal. Of the canalicular testes, 20 were explored by inguinotomy and one by laparoscopy. All the intra-abdominal testes were treated initially by laparoscopy, four being removed due to atrophy, 31 submitted to vascular ligature and 12 to primary orchipexy. Of those submitted to vascular ligature, 22 underwent a second stage orchipexy, of which 18 laparoscopically and 4 by inguinotomy. Of the 18 testes brought to the scrotum by staged laparoscopic orchipexy, 15 (83.3%) presented normal characteristics in the late follow-up, while of the 12 submitted to primary laparoscopic orchipexy, 8 (66.6%) were normal. There were no perioperative or late complications. Conclusions: Laparoscopy is a minimally invasive procedure with low morbidity that enables precise diagnosis of the impalpable testes. When intra-abdominal testes are found, either immediate laparoscopic orchiectomy, or primary and staged orchipexy are possible, with results equivalent to open procedures, with the advantage of smaller surgical incisions and shorter postoperative recovery.en
dc.description.affiliationUnit of Pediatric Urology Division of Urology State University of São Paulo, Rua Curuzú 114, São Paulo, SP 05084-020
dc.format.extent380-385
dc.identifierhttp://www.brazjurol.com.br/julho_2001/Denes_380_385.pdf
dc.identifier.citationBrazilian Journal of Urology, v. 27, n. 4, p. 380-385, 2001.
dc.identifier.file2-s2.0-0034841905.pdf
dc.identifier.issn1517-6878
dc.identifier.scopus2-s2.0-0034841905
dc.identifier.urihttp://hdl.handle.net/11449/66442
dc.language.isoeng
dc.relation.ispartofBrazilian Journal of Urology
dc.rights.accessRightsAcesso aberto
dc.sourceScopus
dc.subjectCryptorchidism
dc.subjectDiagnosis
dc.subjectLaparoscopy
dc.subjectTestis
dc.subjectTreatment
dc.subjectanorchia
dc.subjectchild
dc.subjectcontrolled study
dc.subjectcryptorchism
dc.subjectdiagnostic accuracy
dc.subjectdiagnostic procedure
dc.subjectectopic testis
dc.subjectfollow up
dc.subjecthuman
dc.subjectligation
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectminimally invasive surgery
dc.subjectmorbidity
dc.subjectorchidopexy
dc.subjectorchiectomy
dc.subjectpatient coding
dc.subjectperoperative complication
dc.subjectpostoperative complication
dc.subjectscrotum
dc.subjecttestis atrophy
dc.subjecttestis disease
dc.titleLaparoscopic evaluation and treatment of the impalpable testisen
dc.typeArtigo
dcterms.licensehttp://www.scielo.br/revistas/ibju/paboutj.htm

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