Abstract

Background: An undescended testis is one of the most frequently occurring genito-urinary anomalies in the field of pediatric surgery. Although laparoscopy is considered the most accurate tool in diagnosis of impalpable undescended testis, we outline in this report the importance of p the clinical examination and how it affect he management of the impalpable undescended testis.

Objective: The study objectives were to assess the validity as well as diagnostic power of the selected clinical criteria in diagnosis of impalpable undescended testis.

Methods: A cross-sectional study was carried for all patients were conducted to Alexandria university children hospital A clinical sheet was used when each patient enrolled in the study followed by surgical intervention either by open or laparoscopy to assess the validity of diagnosis based on selected clinical criteria applied in examination of each patient.

Results: According to our selected clinical criteria, we classified impalpable undescended testis into three groups pure intra-abdominal testis, peeping testis and atrophic testis. We had 48 patients (27%) with atrophic testis who showed positive finding by selected clinical criteria which were Assessment of Contra lateral testis. Presence of Ipsilateral intrascrotal nubbin Development of Ipsilateral half of scrotum., Feeling of Ipsilateral rolling of spermatic cord against pubic bone., the selected clinical criteria showed 91% sensitivity and 95.6% specificity in diagnosis of atrophic testis.

Conclusion: Careful and meticulous clinical examination is considered the corner stone in diagnosis and management of impalpable undescended testes especially atrophic one.

Keywords: Impalpable Undescended Testis; Clinical Criteria; Atrophic Testis; Developing Countries

References

1. Ritzén EM., et al. “Nordic consensus on treatment of undescended testes”. Acta Paediatrics 96 (2007): 638-643.
2. Kurpisz M., et al. “Cryptorchidism and long-term consequences”. Reproductive Biology 10 (2010): 19-35.
3. Saber MW., et al. “Retractile testis indicated for orchipexy: a new clinico-sonogrphic concept”. Alexandria Journal of Pediatrics2 (2000): 2-14.
4. Saber MW. “Management of 28 hidden testes with discussion of a new clinical concept”. Bulletin of Alexandria Faculty of Medicine 1110 (2000): 834.
5. Dhanani NN., et al. “Successful outpatient management of the nonpalpable intraabdominal testis with staged fowler-stephens orchiopexy”. Journal of Urology6 (2004): 2399-2401.
6. Godbole PP., et al. “Laparoscopy for the impalpable testis”. British Journal of Surgery 84 (1997): 1430-1432.
7. Zakaria OM., et al. “Examination under anesthesia for management of impalpable undescended testis: a traditional technique revisited”. World Journal of Surgery5 (2013): 1125-1129.
8. Siemer S., et al. “Diagnosis of nonpalpable testes in childhood: comparison of magnetic resonance imaging and laparoscopy in a prospective study”. European Journal of Paediatric Surgery 10 (2000): 114-118.
9. Ang CW and Forrest J. “Diagnostic laparoscopy and management of the impalpable testis--a review of 10 years' practice at a nonpaediatric specialist centre”. Journal of Paediatric Urology 4 (2008): 214-217.
10. Bae KH., et al. “Inguinal approach for the management of unilateral non-palpable testis: is diagnostic laparoscopy necessary?” Journal of Paediatric Urology2 (2014): 233-236.
11. Koff SA. “Does compensatory testicular enlargement predict monorchism?”. Journal of Urology 146 (1991): 632.
12. Hurwitz RS and Kaptein JS. “How well does contralateral testis hypertrophy predict the absence of the nonpalpable testis?”. Journal of Urology2 (2001): 588-592.
13. Snodgrass W., et al. “Initial scrotal incision for unilateral nonpalpable testis”. Journal of Urology 172 (2004): 1742-1745.
14. Snodgrass WT., et al. “Scrotal exploration for unilateral nonpalpable testis”. Journal of Urology 178 (2007): 1718-1721.
15. El-Gohary MA. “Role of laparoscopy in the management of impalpable testes”. Pediatrics Surgery 12 (1997): 463-465.

Citation

Citation: Saber Waheeb., et al. "Clinical Diagnosis for Atrophic Testis … IS it Possible?".Acta Scientific Paediatrics 4.1 (2020): 06-10.

Copyright

Copyright: © 2020 Saber Waheeb., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.