Impalpable undescended testes

Impalpable undescended testes

Impalpable UDTs are absent, canalicular or abdominal. Imaging is unreliable. Examination under anaesthesia and laparoscopy is performed at around 1 year. If palpable under anaesthesia, an inguinal orchidopexy is performed. At laparoscopy , a testis is absent if a blind-ending vas is seen. If the vas and vessels enter the inguinal canal, then the groin is explored. A canalicular testis may be amenable to an inguinal orchidopexy , or there may be a remnant to excise. If there is a viable intra-abdominal testis ( Figure 17.4 ) , a two-stage - Fowler–Stephens orchidopexy is performed. In the first stage, testicular vessels are ligated, leaving the testis in situ , antici - pating survival on the vessels accompanying the vas. Three months later a second operation is performed; if the testis has survived, it is brought into the scrotum.

Figure 17.4 Laparoscopic view of a right-sided intra-abdominal testis visible at the internal ring. Vas (single arrow) and testicular vessels (double arrow).

Impalpable undescended testes

Impalpable UDTs are absent, canalicular or abdominal. Imaging is unreliable. Examination under anaesthesia and laparoscopy is performed at around 1 year. If palpable under anaesthesia, an inguinal orchidopexy is performed. At laparoscopy , a testis is absent if a blind-ending vas is seen. If the vas and vessels enter the inguinal canal, then the groin is explored. A canalicular testis may be amenable to an inguinal orchidopexy , or there may be a remnant to excise. If there is a viable intra-abdominal testis ( Figure 17.4 ) , a two-stage - Fowler–Stephens orchidopexy is performed. In the first stage, testicular vessels are ligated, leaving the testis in situ , antici - pating survival on the vessels accompanying the vas. Three months later a second operation is performed; if the testis has survived, it is brought into the scrotum.

Figure 17.4 Laparoscopic view of a right-sided intra-abdominal testis visible at the internal ring. Vas (single arrow) and testicular vessels (double arrow).

Impalpable undescended testes

Impalpable UDTs are absent, canalicular or abdominal. Imaging is unreliable. Examination under anaesthesia and laparoscopy is performed at around 1 year. If palpable under anaesthesia, an inguinal orchidopexy is performed. At laparoscopy , a testis is absent if a blind-ending vas is seen. If the vas and vessels enter the inguinal canal, then the groin is explored. A canalicular testis may be amenable to an inguinal orchidopexy , or there may be a remnant to excise. If there is a viable intra-abdominal testis ( Figure 17.4 ) , a two-stage - Fowler–Stephens orchidopexy is performed. In the first stage, testicular vessels are ligated, leaving the testis in situ , antici - pating survival on the vessels accompanying the vas. Three months later a second operation is performed; if the testis has survived, it is brought into the scrotum.

Figure 17.4 Laparoscopic view of a right-sided intra-abdominal testis visible at the internal ring. Vas (single arrow) and testicular vessels (double arrow).