Ultrasound examination of paediatric testicles after laparoscopic laser dissection of internal testicular vessels in cryptorchism.

PURPOSE

To evaluate the growth of testicles, their sonographic structure and the recovery of testicular perfusion through collateral vessels after preliminary laparoscopic laser dissection (PLLD) of the internal spermatic artery in cryptorchism.

MATERIALS AND METHODS

The postoperative position, the volume increase, the structural and vascular abnormalities and the incidence of epididymal abnormalities were evaluated with ultrasound in 32 children (mean age: 6.5 +/- 1.34 years) after PLLD. The intratesticular blood flow and the flow-in anastomoses from the deferential and cremasteric arteries were assessed using colour and power Doppler US (7.5 MHz transducer).

RESULTS

All testicles were permanently positioned in the scrotum and showed growth after surgical treatment. None of the testes showed sonographic signs of atrophy. There were no clear differences in intratesticular perfusion compared to the non-operated testis. A collateral blood flow in the deferential artery was found in 44 cases by colour and/or power Doppler US. A perfusion to the lower testicular pole was detected in 29 cases by power Doppler. Intraoperatively, 12 epididymal inversions were eliminated so that an elongated epididymis was sonographically visualised in three testes.

CONCLUSION

Ultrasound can be used for the postoperative control of the testicular structure and the volume increase as well as detection of the flow-in anastomoses. The collateral blood supply after PLLD was sufficient for subsequent growth of testicles in all cases.