Management of the impalpable testis: a six year review together with a national experience

The management of undescended testes remains variable, and the use of lapar oscopy for localisation is controversial. This study reviews the need for l aparoscopy and also assesses the current practice among a cohort of surgeon s. A retrospective review of ail patients undergoing orchidopexy was performed , together with a postal survey of all members of the Welsh Surgical Societ y. Of the 139 orchidopexies performed, the testis was deemed impalpable in 39 (28%) cases. Ah patients were treated with groin exploration, and only in t wo (5%) patients was the testis not located, From the survey, replies were received from 90 (81%) surgeons, of whom 65 (72%) were still performing orc hidopexy. Forty eight (74%) surgeons performed orchidopexy between the age of 2 and 3, and only 32 (36%) performed preoperative investigations. The fo llow up period was variable with the majority of patients seen at six weeks . Laparoscopy for the impalpable testis is not initially warranted. An inguin al exploration is regarded as the definitive investigation. This has the ad vantage of providing the diagnosis and treatment in the majority of cases.