Management of the impalpable testis: long-term results of the preperitoneal approach.

During a 12-year period 396 operations for undescended testes were carried out by one surgeon. In 90 boys the testis was impalpable, and exploration was performed using a muscle-splitting preperitoneal approach. Testicular volume and location were prospectively recorded at 3 months and 1 year, 94% were intrascrotal at 1 year and 84% were judged to have grown. At late follow-up 6 to 16 years (mean, 11 years) after ochidopexy, 81% of testes were in the scrotum and 57% were of normal volume. The value and advantages of this operative approach and its place in the management strategy of the impalpable testis are discussed.