##plugins.themes.bootstrap3.article.main##

Background: Undescended testis (UDT) is of concern to the patient. If not treated may be complicated by trauma, torsion, male sub-fertility, and testicular cancer. In Nigeria it is commonly treated by open orchidopexy or orchidectomy. We report our experience with the laparoscopic management of undescended testes in the Western part of Nigeria.

Methodology: The aim of this study was to report our early experience with the laparoscopic treatment of undescended testis in our centre. The study was conducted between January 2015 and December 2019. The data studied were age, unilateral or bilateral UDT, operation performed, pre-and intra-operative findings, operation time, and the outcome. The data were represented in tables and with operative pictures. Ethical clearance was obtained.

Results: A total 12 patients were treated which consisted of 7 children and 5 adults with a mean age of 11 (6-17) years and 35.2 (29-42) years respectively. Preoperatively, 9 patients had transperitoneal laparoscopic orchidopexy, orchidectomy or varicocelectomy. The laparoscopic findings were peeping testis (5), intraabdominal testis (8), intracanalicular (5), and one absent testis. All the post-orchidopexy testes remained in the scrotum at 18 months of follow up. In the adults, there was improvement in the semen parameters in 2 men while 3 had persistent azoospermia.

Conclusion: In our setting, laparoscopy for undescended testis is feasible, safe, diagnostic, and therapeutic. In infertile men with undescended testis and unilateral varicocele, laparoscopic varicocelectomy results in improved semen quality.

References

  1. F. J. Schneuer, A. J. A. Holland AJ, G. Pereira, S. Jamieson, C. Bower and N. Nassar. (February 2016). “Age at Surgery and outcomes of an undescended Testis,” Pediatrics. [Online]. 137(2). e20152768. Available: https://doi.org/10.1542/peds.2015-2768.
     Google Scholar
  2. A. A. Okeke, and D. N. Osegbe. “Prevalence and characteristics of cryptorchidism in a Nigeria district,” BJU Int, vol. 88 (9), pp. 941-945, Jan. 2021.
     Google Scholar
  3. K. Sijstermans, W. W. MHack, R. W. Meijer, and L. M. van der Voort-Doedens, “The frequency of undescended testis from birth to adulthood: a review,” Int J Andro. vol. 31 (1), pp. 1-11, May 2007.
     Google Scholar
  4. L. H. Braga, A. J. Lorenzo, and R. L. P. Romao. (Jul. 2017). Canadian Urological Association-Pediatric Urologists of Canada (CUA-PUC) guideline for the diagnosis, management, and follow up of cryptorchidism. Can Urol Assoc J. [Online]. 11(7). pp. E251-60. Available: http://dx.doi.org/10.5489/cuaj.4585.
     Google Scholar
  5. A. A. M. Bakr, and M. Kotb, “Laparoscopic orchidopexy: The treatment of choice for the impalpable undescended testis,” JSLS., vol. 2, no. 3, pp. 259-262, Jul-Sep. 1998.
     Google Scholar
  6. R. Kucheria, A. Sahai, T. A. Sami, B. Challacombe, H. Godbole, et al, “Laparoscopic management of cryptorchidism in adults,” European Urology., vol. 48, no. 3, pp. 453-457, Sep. 2005.
     Google Scholar
  7. K. Ismail, M. Ashour, M. El-Afifi, A. Hashish, N El-Dosouky, M. Nagm, and M. Hashish, “Laparoscopy in the management of impalpable testis: series of 64 Cases,” World J Surg., vol. 33, no. 7, pp. 1514-1549, Jul. 2009.
     Google Scholar
  8. C. S. Desai, R. Y. Prabhu, and A. N. Supe. “Laparoscopic orchidectomy for undescended testis in adults,” J Postgrad Med., vol 48, no. 1, pp. 25-26, Jan-Mar. 2002.
     Google Scholar
  9. F. C. Torricelli, M. A. Arap, R. J. Duarte, A. I. Mitre, and M. Srougi. (October 2012). Laparoscopic testicular preservation in adults with intra-abdominal cryptorchidism: is it beneficial? Advances in Urology. [Online]. 2012. 4 pp. Available:
     Google Scholar
  10. https://www.hindawi.com/journals/au/2012/329237.
     Google Scholar
  11. A. O. Talabi, A. O. Adisa, O. Adefehinti, O. A. Sowande, A. C. Etonyeaku, and O. Adejuyigbe. (Jun. 2015). Early experience with laparoscopic surgery in children in Ile-Ife, Nigeria. Afr J Paediatr Surg. [Online]. 12(1). pp. 29-32. Available: https://www.afrjpaedsurg.org/text.asp?2015/12/1/29/150947.
     Google Scholar
  12. O. H. Ekwunife, V. I. Modekwe, J. O. Ugwu, and C. A. Ugwunne, “Early experience with laparoscopic management of nonpalpable undescended testes,” Niger J Surg., vol. 23, no. 2, pp. 115-118, Oct. 2017.
     Google Scholar
  13. O. A. Sowande, A. O. Talabi, A. C. Etonyeaku, and O. Adejuyigbe, “Groin exploration for the non-palpable testes: A single center experience” Niger J Surg., vol. 21, no. 1, pp. 56-59, Mar. 2015.
     Google Scholar
  14. S. C. Ekpemo, and C. Onyearugha, “Management of undescended testis in children in Aba Nigeria,” International J of Clinical Urology., vol. 3, no. 1, pp. 15-17, Jun. 2019.
     Google Scholar
  15. E. A. Ameh, and H. N. Mbibu, “Management of undescended testes in children in Zaria, Nigeria,” East Afr Med J., vol. 77, no. 9, pp. 485-487, Sep. 2000.
     Google Scholar
  16. M. M. AbdElsalam, K. M. Elshimy, A. M. Elbatarny, and M. A. Elafifi, “Role of laparoscopy in management of non-palpable undescended testis in children,” The Egyptian J Hospital Med., vol. 76, no. 2, pp. 3454-3459, July 2019.
     Google Scholar
  17. S. A. Dar, R. S. Bali, Y. Zahoor, A. R. Kema, R. and Bhardwaj. (Oct. 2018). Undescended testes and laparoscopy: Experience from the developing world. Adv Urol. [Online]. 2018. 5 pages. Available: https://www.hindawi.com/journals/au/2018/1620470.
     Google Scholar
  18. C. Foresta, D. Zuccarello, A. Garolla, and A. Ferlin, “Role of Hormones, Genes, and environment in human cryptorchidism” Endocrine Reviews., vol. 29, no. 5, pp. 560-580, Aug. 2008.
     Google Scholar
  19. N. E. Skakkebaek, E. Rajpert-De Meyts, and K. M. Main, “Testicular dysgenesis syndrome: an increasingly common developmental disorder with environmental aspects: Opinion,” Human Reproduction., vol. 16, no. 5, pp. 972-978, May 2001.
     Google Scholar