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Evaluation of diagnostic methods in children with nonpalpable undescended testis

Korean Journal of Pediatrics 2006;49(7):732-736.
Published online July 15, 2006.
Evaluation of diagnostic methods in children with nonpalpable undescended testis
Noh Sung Seok, Hong Jin Suh, Dong Hwan Lee
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
비촉지성 정류고환의 진단 방법의 평가
석노성, 서홍진, 이동환
가톨릭대학교 의과대학 비뇨기과학교실
Correspondence: 
Hong Jin Suh, Email: suhhong@olmh.ac.kr
Abstract
Purpose
: Numerous methods exist for diagnosing nonpalpable testis in treatment of cryptochidism. However, there is no clinically established data for the rational diagnostic tool of nonpalpable testis in terms of expenses. We tried to establish a current conventional diagnostic course of nonpalpable testis. We then evaluated the efficacy of ultrasonography, physical examination under general anesthesia and laparoscopy for diagnosing nonpalpable testis.
Methods
: Between March 2000 and February 2005, 103 boys(129 testes) with undescended testes were treated in our department. There were 31 testes(24.0%) that were not palpable at physical examination. These patients were evaluated with ultrasonography and repeated physical examination under general anesthesia. In the cases where testes could not be detected with ultrasonography and physical examination under general anesthesia, laparoscopy was performed to diagnose nonpalpable testis.
Results
: In 31 cases of nonpalpable testis, 13 testes were detected with ultrasonography and 15 testes became palpable with physical examination under general anesthesia. All of the remaining 16 nonpalpable testes were confirmed with laparoscopy.
Conclusion
: Physical examination under general anesthesia was superior to ultrasonography in making a diagnosis of nonpalpable testis. Ultrasonography and physical examination under general anesthesia could reduce the incidence of diagnostic laparoscopy. Therefore, it is recommended that ultrasonography, physical examination under general anesthesia and laparoscopy must be performed conventionally in order to diagnose nonpalpable testis.
Key Words: Testis , Cryptorchidism , Diagnosis , Physical examination , Ultrasonography


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