Abstract
Undescended testes, one of the commonest conditions managed by pediatric surgeons and urologists has increased risk of malignancy and reduced fertility. While the treatment of choice for palpable testis is orchidopexy as an open procedure, those with impalpable testis require evaluation by laparoscopy in the first instance. Further management options vary depending on the findings, which are hard to predict preoperatively. The surgeon embarking on an operation for an impalpable testicle needs to be prepared and has the skills to deal with a variety of scenarios.
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References
Sistermans K, Hack WWM, Meijer RW, Van der Voort-Doedens LM. The frequency of undescended testis from birth to adulthood: a review. Int J Androl. 2007;31(1):1–11.
Lip SZ, Murchison LE, Cullis PS, Govan L, Carachi R. A meta-analysis of the risk of boys with isolated cryptorchidism developing testicular cancer in later life. Arch Dis Child. 2013;98(1):20–6.
Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O. Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med. 2007;356(18):1835–41.
Higgins E, Smith DE, Gao D, Wilcox D, Cost NG, Saltzman AF. The impact of age at orchiopexy on testicular cancer outcomes. World J Urol. 2019;38:2531–6.
Walsh TJ, Dall’Era MA, Croughan MS, Carroll PR, Turek PJ. Prepubertal orchidopexy for cryptorchidism may be associated with lower risk of testicular cancer. J Urol. 2007;178:1440–6.
Fertility guidelines. European association of urology. Cryptorchidism. 2017. http://uroweb.org/guideline/male-infertility/#5_6.
Kollin C, Stukenborg JB, Nurimo M, Sudqvist E, Gustafsso T, Soder O, Toppari J, Nordenskjold A, Ritzen EM. Boys with undescended testes: endocrine, volumetric and morphometric studies on testicular function before and after orchidopexy at nine months or three years of age. Endocr Res. 2012;97(12):4588–95.
Clinical knowledge summary. NICE. Undescended testes. 2020. https://cks.nice.org.uk/undescended-testes#!topicSummary.
British Association of Paediatric Surgeons, British Association of Paediatric Urologists, Association of Paediatric Anaesthetists, UK National Screening Committee. Commissioning guide: paediatric orchidopexy for undescended testis. 2015. http://www.bapu.org.uk/documents/consensus.
Mostafa IA, Shalaby MS, Woodward MN. Bilateral orchidopexies: synchronous or metachronous? Survey of BAPS and BAPU members and single-Centre comparison. J Pediatr Surg. 2019;54(2):310–2.
Ahmed SF, Achermann JC, Arlt W, Balen A, Conway G, Edwards Z, Elford S, Hughes IA, Izatt L, Krone N, Miles H, O’Toole S, Perry L, Sanders C, Simmonds M, Watt A, Willis D. Society for endocrinology UK guidance on the initial evaluation of an infant or an adolescent with a suspected disorder of sex development. Clin Endocrinol. 2015;84(5):771–88.
BJUI. Surgery for undescended testes: open and laparoscopic. 2019. https://doi.org/10.18591/BJUIK.0241.
Shehata SM, Shehata SMK, Baky Fahmy MA. The intra-abdominal testis: lessons from the past, and ideas for the future. Pediatr Surg Int. 2013;29:1039–45.
Shehata S, Shalaby R, Ismail M, Abouheba M, Elrouby A. Staged laparoscopic traction-orchidopexy for intraabdominal testis (Shehata technique): stretching the limits for preservation of testicular vasculature. J Pediatr Surg. 2016;51(2):211–5.
Okur H, Alkan Y, Karakaya AE, Guzel M. Microvascular orchidopexy. J Pediatr Urol. 2007;3(1):88.
Macmaster University. One vs two stage gubernacular sparing laparoscopic orchidopexy (GSLO). Clinical Trial Identifier NCT02936024 Expected completion. 2021.
Roy C, Cullis PS, Clark C, Munro FD. Retrospective analysis of testicular outcomes following laparoscopic two-stage fowler Stephens orchidopexy. J Pediatr Surg. 2020;55(2):300–3.
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Middleton, T., Salahuddin, S., Subramaniam, R. (2022). Management of Impalpable Testis. In: Esposito, C., Subramaniam, R., Varlet, F., Masieri, L. (eds) Minimally Invasive Techniques in Pediatric Urology. Springer, Cham. https://doi.org/10.1007/978-3-030-99280-4_56
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