The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis
OBJECTIVE: Evaluate the results from the first 5 years of experience with laparoscopy for diagnosis and treatment of nonpalpable testes. MATERIALS AND METHODS: Medical records of 51 patients submitted to laparoscopic testicular exploration, during a 5-year period, were retrospectively analyzed. Pati...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
2003-08-01
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| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382003000400011 |
| _version_ | 1828408421644238848 |
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| author | Daniel G Bittencourt Márcio L Miranda Ana P.P Moreira Shoji Miyabara J.M Bustorff-Silva |
| author_facet | Daniel G Bittencourt Márcio L Miranda Ana P.P Moreira Shoji Miyabara J.M Bustorff-Silva |
| author_sort | Daniel G Bittencourt |
| collection | DOAJ |
| description | OBJECTIVE: Evaluate the results from the first 5 years of experience with laparoscopy for diagnosis and treatment of nonpalpable testes. MATERIALS AND METHODS: Medical records of 51 patients submitted to laparoscopic testicular exploration, during a 5-year period, were retrospectively analyzed. Patients' mean age was 65.7 months (median = 48) on the first procedure. The youngest patient was 10 months and the oldest was 14 years old on the first surgery. Twenty-four (47%) patients presented nonpalpable testes bilaterally, 7 (14%) only at the right side and 20 (39%) at the left, totaling 75 testicular units assessed. Patients who had their testes palpated after anesthetic induction were excluded from the study, and in all other cases, surgical management was based on the testicular position and viability. During the post-operative follow-up, surgical success was classified as palpable testis in scrotal sac, with adequate consistency and volume. RESULTS: Nine (12%) testes were not localized, but their vessels and deferent duct were atrophic. Two (3%) testes were intra-abdominal and atrophic, and 2 (3%) gonads, in the same patient, had a dysmorphic aspect. Nineteen (25%) testicular units were located close to the internal inguinal ring (peeping testes) and, in 22 (29%) units, the spermatic vessels and deferent duct penetrated the internal inguinal ring. Eight (10%) testes were located at a distance of less than 2 cm from the internal inguinal ring and 13 (17%) at a distance greater than 2 cm. The 2 intra-abdominal atrophic testes were removed. Inguinotomy was performed in a total of 41 (54%) cases, reaching a surgical success of 89%. Laparoscopic orchiopexy in one stage, without vascular ligation, was performed in 9 (12%) testes, which presented a distance of less than 2 cm from the internal inguinal ring, also with a surgical success index of 89%. Orchiopexy in 2 stages, with ligation of the spermatic vessels, was performed in 13 (17%) testicular units located at a distance greater than 2 cm from the internal inguinal ring, reaching 77% of good results. CONCLUSION: Videolaparoscopy is a safe and effective method for diagnosis and treatment of nonpalpable testis. |
| first_indexed | 2024-12-10T11:39:35Z |
| format | Article |
| id | doaj.art-8e28daf03d4f44c58d84607f86bd7fc0 |
| institution | Directory Open Access Journal |
| issn | 1677-5538 1677-6119 |
| language | English |
| last_indexed | 2024-12-10T11:39:35Z |
| publishDate | 2003-08-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-8e28daf03d4f44c58d84607f86bd7fc02022-12-22T01:50:19ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-55381677-61192003-08-0129434535210.1590/S1677-55382003000400011The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testisDaniel G BittencourtMárcio L MirandaAna P.P MoreiraShoji MiyabaraJ.M Bustorff-SilvaOBJECTIVE: Evaluate the results from the first 5 years of experience with laparoscopy for diagnosis and treatment of nonpalpable testes. MATERIALS AND METHODS: Medical records of 51 patients submitted to laparoscopic testicular exploration, during a 5-year period, were retrospectively analyzed. Patients' mean age was 65.7 months (median = 48) on the first procedure. The youngest patient was 10 months and the oldest was 14 years old on the first surgery. Twenty-four (47%) patients presented nonpalpable testes bilaterally, 7 (14%) only at the right side and 20 (39%) at the left, totaling 75 testicular units assessed. Patients who had their testes palpated after anesthetic induction were excluded from the study, and in all other cases, surgical management was based on the testicular position and viability. During the post-operative follow-up, surgical success was classified as palpable testis in scrotal sac, with adequate consistency and volume. RESULTS: Nine (12%) testes were not localized, but their vessels and deferent duct were atrophic. Two (3%) testes were intra-abdominal and atrophic, and 2 (3%) gonads, in the same patient, had a dysmorphic aspect. Nineteen (25%) testicular units were located close to the internal inguinal ring (peeping testes) and, in 22 (29%) units, the spermatic vessels and deferent duct penetrated the internal inguinal ring. Eight (10%) testes were located at a distance of less than 2 cm from the internal inguinal ring and 13 (17%) at a distance greater than 2 cm. The 2 intra-abdominal atrophic testes were removed. Inguinotomy was performed in a total of 41 (54%) cases, reaching a surgical success of 89%. Laparoscopic orchiopexy in one stage, without vascular ligation, was performed in 9 (12%) testes, which presented a distance of less than 2 cm from the internal inguinal ring, also with a surgical success index of 89%. Orchiopexy in 2 stages, with ligation of the spermatic vessels, was performed in 13 (17%) testicular units located at a distance greater than 2 cm from the internal inguinal ring, reaching 77% of good results. CONCLUSION: Videolaparoscopy is a safe and effective method for diagnosis and treatment of nonpalpable testis.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382003000400011testiscryporchidismdiagnosistherapeuticslaparoscopy |
| spellingShingle | Daniel G Bittencourt Márcio L Miranda Ana P.P Moreira Shoji Miyabara J.M Bustorff-Silva The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis International Brazilian Journal of Urology testis cryporchidism diagnosis therapeutics laparoscopy |
| title | The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis |
| title_full | The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis |
| title_fullStr | The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis |
| title_full_unstemmed | The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis |
| title_short | The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis |
| title_sort | role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis |
| topic | testis cryporchidism diagnosis therapeutics laparoscopy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382003000400011 |
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