The role of laparoscopy in the management of impalpable testes.

Both diagnostic and operative laparoscopy were used in the management of 68 impalpable testes. Twenty-three were either vanishing or atrophied, and were associated with a precarious blood supply. Two were found in the groin, 12 in the inguinal canal, and 32 at variable distances from the internal ring; of these, 2 were in a patient with persistent müllerian duct syndrome. Two atrophied abdominal testes were removed laparoscopically, 3 patients underwent a two-stage Fowler-Stephens procedure, and 28 underwent one-stage, laparoscopically assisted orchidopexy. An algorithm for surgical management of the impalpable testis based on laparoscopic findings is proposed.