NON-PALPABLE TESTES - ORCHIOPEXY IN SINGLE-STAGE

From 1986 to 1990, 53 non-palpable testes were treated in the departme nt of Pediatric Surgery and Endocrinology at the Regina Marghertia Hos pital, Turin, Italy. The reported patients were 45, 8 of them were bil ateral with both testes non-palpable, 13 of the remaining patients wer e right cryptorchid and 24 were left.All patients received medical tre atment, by LH-RH nasal spray and HCG, before surgery. None of the non- palpable testes descended by hormone therapy only, so that surgical ex ploration was always required. In the 53 reported cases, 10 gonads wer e not found, 13 were atrophic and 30 were abdominal. All abdominal gon ads were positioned into the scrotum by orchiopexy in a single stage. Half of the patients underwent operation before the age of 2. Therefor e, it is to be pointed out that the younger a patient the shorter his inguinal canal, this facilitates orchiopexy for high, undescended test es. In 10 patients a testicular biopsy was made during surgical proced ure. Normal morphology and normal spermatogonia content were observed in the abdominal testes of the patients who had reached the age of 1 y ear. During the follow-up of the reported patients no upward displacem ent was observed. Eleven patients underwent postoperative testicular u ltrasonography which showed that parenchymal structure of the operated testis was normal and the volume of the testis was slightly smaller t han normal. Based on their experience, the authors suggest to correct cryptorchidism before the age of one year, surgical procedure follows immediatly after ineffective hormone therapy.