Impalpable testis

Impalpable testis

For non-palpable testes under anaesthesia, diagnostic laparos - copy is recommended. If a testis is found during laparoscopy , the options are: 1 Laparoscopic orchidopexy preserving the vessels: the testis is dissected o ff a triangular pedicle containing the testicular vessels and the vas. 2 Laparoscopic one-stage Fowler–Stephens orchidopexy: vessels are divided and the testis is dissected o ff a pedicle of the vas and brought down in one stage. 3 Laparoscopic two-stage Fowler–Stephens orchidopexy: vessels are divided with clips but dissection of the testis is postponed for 6 months to allow for optimal development of collaterals. has to determine the presence of either blind-ending vessels or a testicular nubbin to completely rule out a missing testis. The vas can be dissociated from the testis and thus is not always a good guide to find the gonad. If the internal ring is closed but vessels are going into it, a scrotal exploration usually will find a testicular nubbin. If vessels are going into an open inguinal ring, one can usually push the testis into the abdomen; if not, an inguinal or scrotal exploration would be warranted.