LAPAROSCOPIC ORCHIOPEXY FOR INTRA-ABDOMINAL TESTES: OUR EXPERIENCE
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Abstract
Undescended testis or cryptorchidism is the absence of one or both testes in normal scrotal position and during initial clinical evaluation may refer to palpable or non palpable testes, which are either cryptorchid or absent. Undescended testis is one of the most common congenital anomalies, occurring in 1% to 9% of full- term and 1% to 45% of preterm new born males'. The exact etiology is still unclear. Some Predisposing factors: as low birth weight, short gestational period, low intra-abdominal pressure, chromosomal anomalies, and hormonal factors2.
Syndromes associated with UDT includes Androgen biosynthesis defects3, Androgen insensitivity, Leydig cell ageneis, Gonadotropin deficiency disorders, Klinefelter syndromes, Down syndrome,All cases of classical prune belly, Spigelian hernia, cerebral palsy, omphalocele, gastroschisis, PUV. Complications of Undescended testis are reduced fertility, Torsion, Trauma, Testicular tumor5, Epididymo-orchitis, Inguinal hernia.
In large clinical series, the majority (75% to 80%) of undescended testes are palpable and 60% to 70% are unilateral: Approximately 20% of UT cases are non-palpable and non-palpable testicles (NPT) may be intraabdominal, canalicular, atrophic, or absent. Inguinoscrotal ultrasonography and magnetic resonance imaging (MRI) are not usually helpful and are not recommended in the evaluation and management of a nonpalpable testis6. Laparoscopy has gradually become the gold standard for localization (with 99% sensitivity) and eventual treatment of NPT when the testicle is still nonpalpable under general anesthesia7.
References
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Dr Mukesh C Arya
Professor and HOD, Dept of urology, SPMC, Bikaner
Dr Pradyot Shahi
Senior Resident, Dept of Urology, SPMC, Bikaner
Dr Yogendra
Asst Professor, Dept of Urology, SPMC, Bikaner
Dr Somit Kumar
Senior resident, Dept of Urology, SPMC, Bikaner