The Role of Laparoscopy in Managing Impalpable Undescended Testes in a Tertiary Hospital.

Abstract

One of the most prevalent congenital defects in boys is undescended testes. Ultrasound is commonly employed to locate the testis in cases of impalpable testes, which frequently yields false-negative results. Laparoscopy has gained widespread acceptance recently for managing impalpable testes. Objective of the study was to evaluate the efficacy, safety and diagnostic accuracy of laparoscopy in the management of impalpable undescended testes (UDT) in a tertiary care setting. To Assess, analyze the outcome of laparoscopic orchiopexy and orchiectomy and highlight the advantages of laparoscopy over traditional diagnostic and surgical methods. This was a prospective type of observational study of all children with impalpable testes presenting for laparoscopy from January 2022 to July 2024 in the department of Pediatric Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh who had undergone ultrasound examinations without localizing the testes was conducted and the role of laparoscopy in diagnose with managing impalpable testes. Those patient are included in this study who are clinically impalpable and on ultrasound near deep ring or abdominal and excluded those who are clinically palpable and ultrasound can locate the testis within inguinal canal and ambiguous geneitalia by karyotyping. Total 56 patients were included among them 67 were impalpable testes. The age ranges from 1 to 12 years. Initially site and size of testes were identified by abdominopelvic USG in all 56 patients. Single stage laparoscopic orchidopexy was done in 40 testes, stage procedure underwent 18 testes, laparoscopic orchiectomy was done in 9 testes. Follow-up by clinical examination Doppler ultrasound in selected patient for 6 months. Atrophy of testis occurred in 2 patients during this follow-up period. Laparoscopy has revolutionized the management of impalpable UDT, providing a reliable, safe, and effective method to diagnose and treat this condition. Its advantages make it the preferred approach for pediatric surgeons when dealing with non-palpable testicles.