THE VALUE OF LAPAROSCOPY IN THE LOCALIZATION OF THE IMPALPABLE TESTIS

Objective: To determine the value of laparoscopic findings in localizi ng the impalpable testis, and more particularly, which laparoscopic fi ndings render exploration and therapeutic operation unnecessary. Desig n: A prospective laparoscopic study of patients with impalpable testes . Setting: King Fahd Hospital of the University, Al-Khobar, Saudi Arab ia. Subjects: Over a period of 5 years, 28 consecutive patients with 3 8 non-palpable testes were introduced into the study. Results: The tec hnical success rate of laparoscopy was 92.8%. A higher incidence of im palpable testis was observed on the right side than on the left, a mar ked departure from earlier reports in the literature. The testis was p resent in 73.7% of cases and absent in 26.3%. All but one testis was i ntra-abdominal. There was complete correlation between findings at lap aroscopy and exploration. Conclusions: Laparoscopy is a safe and valua ble procedure in localizing the impalpable testis. Laparoscopic findin g of blind-ending testicular vessels in isolation or in association wi th a blind-ending vas deferens (vanishing testis) was the only factor, in our experience, which reflects the absence of a testis and, theref ore, should render exploration and therapeutic operation unnecessary.