Ali M S, Mahmud A A, Islam S, Bari M S, Mokarabin M, Baten M A, Al Mamun M A, Karmaker R N, Hossain M B
Dr Mohammad Showkot Ali, Assistant Professor, Department of Pediatric Surgery, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2025 Jan;34(1):85-89.
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.
男孩中最常见的先天性缺陷之一是隐睾。对于触诊不到睾丸的情况，超声通常用于定位睾丸，但经常产生假阴性结果。近年来，腹腔镜检查在处理触诊不到的睾丸方面已得到广泛认可。本研究的目的是评估在三级医疗环境中腹腔镜检查在处理触诊不到的隐睾（UDT）方面的疗效、安全性和诊断准确性。评估、分析腹腔镜睾丸固定术和睾丸切除术的结果，并突出腹腔镜检查相对于传统诊断和手术方法的优势。这是一项前瞻性观察性研究，对2022年1月至2024年7月在孟加拉国迈门辛市迈门辛医学院医院小儿外科接受腹腔镜检查的所有触诊不到睾丸的儿童进行研究，这些儿童在接受超声检查时未发现睾丸位置，研究腹腔镜检查在诊断和处理触诊不到的睾丸中的作用。纳入本研究的患者为临床上触诊不到且超声检查显示睾丸靠近内环或位于腹部的患者，排除临床上可触及且超声能在腹股沟管内定位睾丸以及通过核型分析诊断为生殖器模糊的患者。共纳入56例患者，其中有67个触诊不到的睾丸。年龄范围为1至12岁。最初，所有56例患者均通过腹部盆腔超声检查确定睾丸的位置和大小。40个睾丸进行了一期腹腔镜睾丸固定术，18个睾丸进行了分期手术，9个睾丸进行了腹腔镜睾丸切除术。对部分患者进行了6个月的临床检查和多普勒超声随访。在此随访期间，有2例患者出现睾丸萎缩。腹腔镜检查彻底改变了触诊不到的UDT的处理方式，为诊断和治疗这种疾病提供了一种可靠、安全且有效的方法。其优势使其成为小儿外科医生处理不可触及睾丸时的首选方法。
