Abstract

Cryptorchidism is the most frequent anomaly in sexual development in male children. The ideal diagnostic method to investigate patients with nonpalpable testes has not been found to date, but many methods have been described. Between 1983 and 1991, 45 patients 2 to 35 years old underwent laparoscopy as a diagnostic method in investigation of nonpalpable testis, and our first laparoscopic pediatric orchiectomy was performed. Of 45 patients studied, 37 (82%) underwent exploration, and a complete correlation between laparoscopic and operative findings was observed. There were four complications such as subperitoneal or omental emphysema in three patients; however, these conditions did not preclude the complete examination. In one patient, bleeding aroused suspicion of visceral or vascular injury, but laparotomy revealed that the blood came from the abdominal wall. Laparoscopic orchiectomy was indicated in a 5-year-old child evaluated for ambiguous external genitalia. Based on our experience, we may conclude that in 37% of nonpalpable testes, a confirmatory operation is not necessary, and laparoscopic orchiectomy is a minimally invasive technique that should be used in cases in which orchiectomy is indicated.