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Laparoscopic versus Open orchiopexy approach for the management of non- palpable undescended testis (Abstract)

Gouda Mohamed El-labban


Abstract

Introduction: Treatment of the cryptorchid testicle is justified due to the increased risk of infertility and malignancy. The optimal initial surgical approach for non-palpable undescended testis is debated. In these cases, the laparoscopic technique is a useful alternative method for diagnosis and treatment. Aim: To evaluate the use of laparoscopic orchiopexy approach versus open orchiopexy approach in the management of non-palpable undescended testis regarding success rate, operative time, complications, hospital stay, oral feeding and return to normal activities. Methods: A total of 94 operations of either laparoscopic (group 1; n=46) or open (group 2; n=48) orchiopexy for non-palpable undescended testes were evaluated. The location of testes and results of orchiopexy were compared in both groups. Results: The majority of testes (38/46 group 1 and 43/48 group 2) in both groups were intra-abdominal. Laparoscopic orchiopexy is similar to open orchiopexy in mean operative time and overall success rate. The success rate was 91.3% and 89.6% in the two groups respectively. Laparoscopic orchiopexy is superior in terms of length of hospital stay, starting oral feeding and return to normal activities. Conclusions: Laparoscopic and open approaches to non-palpable undescended testis give comparable results. Laparoscopy is the only exploratory procedure that is accurate enough to enable the diagnosis of non-palpable testis and also allow the surgical treatment to be done in the same setting.

Key words: non-palpable, undescended testis, laparoscopy, orchiopexy, cryptorchid