IS INGUINAL EXPLORATION FOR THE IMPALPABLE TESTIS AN OUTDATED OPERATION

Objective To evaluate the reliability of open inguinal exploration for the investigation of the impalpable testis by reviewing laparoscopic findings after previous negative inguinal exploration. Patients and me thods Laparoscopy was performed in 18 boys (with a total of 22 impalpa ble testes) in whom previous inguinal exploration in their referring h ospitals had yielded negative or inconclusive findings. Subsequent man agement of the impalpable testes was based on laparoscopic findings. R esults Despite previous negative surgical findings at inguinal explora tion, laparoscopy revealed that 13 of the 22 impalpable testes (59%) w ere present, 12 within the abdomen and one in the inguinal canal. Abse nce of the remaining nine testes was positively confirmed by visualizi ng confluent blind ending vas and vessels. Conclusion Inguinal explora tion is an unreliable method of investigating the impalpable testis, w ith an unacceptably high incidence of false-negative or inconclusive f indings. Laparoscopy should be undertaken as the initial diagnostic ma noeuvre of choice.