Journal Mobile Options
Table of Contents
Vol. 75, No. 4, 2005
Issue release date: December 2005
Urol Int 2005;75:337–339
(DOI:10.1159/000089170)

Laparoscopic Management of the Adult Nonpalpable Testicle

Corvin S. · Sturm W. · Anastasiadis A. · Kuczyk M. · Stenzl A.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Objectives: This report describes own experiences with laparoscopic management of adult men with cryptorchidism. Patients and Methods: 8 men with nonpalpable testes were referred to our department. Laparoscopy was used to assess the presence and location of the gonad and perform an orchiectomy or orchidopexy, respectively. Results: A uni-/bilateral atrophic testicle was palpable in 2 patients under general anesthesia and removed after inguinal exploration. In 4 individuals the testicular vessels and vas deferens were found laparoscopically entering the internal inguinal ring. Two vanishing testicles and 2 atrophic gonads were removed during subsequent inguinal exploration. In 1 patient with a solitary testis, a morphologically intact abdominal testicle was presented. In this patient, endocrine function was lost completely after stage 1 of a Fowler-Stephens orchidopexy. In 1 patient an atrophic abdominal testicle was removed laparoscopically. Conclusions: These results demonstrate the suitability of laparoscopy for the treatment of cryptorchidism in the adult population. In most cases, atrophic inguinal gonads or vanishing testicles are found and should be removed. Our results suggest that in cases of intact abdominal testicles, Fowler-Stephens orchidopexy with transection of the spermatic vessels should be avoided to preserve endocrine function of the gonad.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Lee PA, Coughlin MT: Fertility after bilateral cryptorchidism. Evaluation by paternity, hormone, and semen data. Horm Res 2001;55:28–32.
  2. Cortes D, Thorup JM, Visfeldt J: Cryptorchidism: aspects of fertility and neoplasms. Horm Res 2001;55:21–27.
  3. Hadziselimovic F, Herzog B: Importance of early postnatal germ cell maturation for fertility of cryptorchid males. Horm Res 2001;55:6–10.
  4. Hadziselimovic F, Herzog B, Buser M: Development of cryptorchid testes. Eur J Pediatr 1987;146(suppl 2):S8.

    External Resources

  5. Kogan SJ, Tennenbaum S, Gill B, Reda E, Levitt SB: Efficacy of orchidopexy by patient age 1 year for cryptorchidism. J Urol 1990;144:508–509.
  6. Schindler AM, Diaz P, Cuendet A, Sizonenko PC: Cryptorchidism: a morphological study of 670 biopsies. Helv Paediatr Acta 1987;42:145–158.
  7. Moller H, Cortes D, Engholm G, Thorup J: Risk of testicular cancer with cryptorchidism and with testicular biopsy: cohort study. BMJ 1998;317:729.
  8. Baker LA, Docimo SG, Surer I, Peters C, Cisek L, Diamond DA, Caldamone A, Koyle M, Strand W, Moore R, Mevorach R, Brady J, Jordan G, Erhard M, Franco I: A multi-institutional analysis of laparoscopic orchidopexy. BJU Int 2001;87:484–489.
  9. Sousa A, Gayoso R, Lopez-Bellido D, Reboredo J, Perez-Valcarcel J, Fuentes M: Laparoscopic assessment and orchidectomy for the adult undescended testis. Surg Laparosc Endosc Percutan Tech 2000;10:420–422.
  10. Yeung CK, Tam YH, Chan YL, Lee KH, Metreweli C: A new management algorithm for impalpable undescended testis with gadolinium-enhanced magnetic resonance angiography. J Urol 1999;162:998–1002.
  11. Ivanov A, Dewey C, Fahlenkamp D, Luning M: MRT in nonpalpable testes (in German). Rofo 1994;160:249–253.
  12. Hrebinko RL, Bellinger MF: The limited role of imaging techniques in managing children with undescended testes. J Urol 1993;150:458–460.
  13. Cisek LJ, Peters CA, Atala A, Bauer SB, Diamond DA, Retik AB: Current findings in diagnostic laparoscopic evaluation of the nonpalpable testis. J Urol 1998;160:1145–1149.
  14. Breda G, Nakada SY, Rassweiler JJ: Future developments and perspectives in laparoscopy. Eur Urol 2001;40:84–91.
  15. Merguerian PA, Mevorach RA, Shortliffe LD, Cendron M: Laparoscopy for the evaluation and management of the nonpalpable testicle. Urology 1998;51:3–6.
  16. Cortes D, Thorup JM, Lenz K, Beck BL, Nielsen OH: Laparoscopy in 100 consecutive patients with 128 impalpable testes. Br J Urol 1995;75:281–287.
  17. Hauser R, Lessing JB, Samuel D, Yavetz H, Peyser MR, Paz GF, Homonnai Z: Management of bilateral nonpalpable testes: laparoscopic diagnosis and orchiectomy. Int J Androl 1994;17:74–77.
  18. Montanari E, Trinchieri A, Zanetti G, Rovera F, Nespoli R, Dell’Orto P, Austoni E, Pisani E: Andrological laparoscopy. Ann Urol 1995;29:106–112.
  19. Sexton WJ, Assimos DG: Diagnostic and therapeutic laparoscopy for the adult cryptorchid testicle. Tech Urol 1999;5:24–28.
  20. Stepanov VN, Kadyrov ZA, Tomkevich BA, Rozikov IS, Pushik AM: The laparoscopic treatment of abdominal cryptorchidism in adults (in Russian). Urol Nefrol (Mosk) 1997;5:12–13.

    External Resources

  21. Rogers E, Teahan S, Gallagher H, Butler MR, Grainger R, McDermott TE, Thornhill JA: The role of orchiectomy in the management of postpubertal cryptorchidism. J Urol 1998;159:851–854.
  22. Humphrey GM, Najmaldin AS, Thomas DF: Laparoscopy in the management of the impalpable testis. Br J Surg 1998;85:983–985.


Pay-per-View Options
Direct payment This item at the regular price: USD 33.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 23.00