IMPACT OF DIAGNOSTIC LAPAROSCOPY IN THE MANAGEMENT OF THE UNILATERAL IMPALPABLE TESTIS

Objective To evaluate the impact of laparoscopy on the management of c hildren with a unilateral impalpable testis. Patients and methods The study population consisted of 27 children who underwent a primary ingu inal exploration for a unilateral impalpable testis. Results Twelve of 27 (44%) children had inguinal or 'peeping' testes and 10 of 27 (37%) had blind-ending vasa and vessels in the inguinal canal; four of thes e 10 had atrophic tubular tissue in the excised remant. Four of 27 (15 %) had blind-ending vasa and vessels proximal to the internal ring. On ly one child had a testis proximal to the internal ring. Only the four children (15%) with blind-ending vasa and vessels proximal to the int ernal ring would have benefited from a laparoscopy by avoiding an ingu inal exploration. Conclusions Because of the time, expense and limited usefulness of laparoscopy in altering the management of children with a unilateral unpalpable testis, we reserve laparoscopy for cases wher e inguinal exploration has failed.