Outcome of surgical management of non-palpable testes

BACKGROUND: We reviewed the success rates of orchidopexies performed for non-palpable testes at our institution and correlated preoperative and intraoperative findings to eventual outcomes. MATERIALS AND METHODS: We retrospectively reviewed ninty five medical records of patients who underwent laparoscopic exploration for the assessment of a non-palpable testes between 1996 and 2009. Intra-operative data for one hundrad eight non-palpable testes were collected. Operative success was defined as a testis comparable in size or slightly smaller than the contra-lateral testis with normal consistency on the last follow-up. RESULTS: There were seventy (65%) viable testes at exploration, thirty one nubbins (29%) removed and 7 (6%) absent. In the seventy six unilateral cases, contra-lateral hypertrophy was found in twinty five (33%) testes. Of which, twinty one (84%) were associated with absent testes or finding of a nubbin rather than a viable testis. In contrast, absent testes or finding of a nubbin was noted in 12 of 51 (23.5%) patients without contra-lateral hypertrophy. The difference was statistically significant (P < 0.001). Mean follow-up was seventeen months. Of the fifty testes in which the testicular artery was preserved, 7 were lost to follow-up and 3 of the remaining fourty three (7%) were atrophic. The twinty testes that underwent Fowler-Stephens orchidopexy (FSO) had a similar rate of atrophy, with only 1 (5%) atrophic testis identified following staged FSO (P > 0.83). INTERPRETATION: Testicular atrophy rate was similar in both artery sparing and Fowler-Stephens orchidopexies. Contra-lateral hypertrophy was significantly associated with absent testes or finding of a nubbin rather than a viable testis.