الفهرس | Only 14 pages are availabe for public view |
Abstract Cryptorchidism is the most common congenital anomaly of the male reproductive system, as it affects 3% of full term male newborns and 0.8% of male infants at 1 year of age. The most important common complications of cryptorchidism are infertility and malignant transformation. Impalpable testis offers a greater diagnostic and therapeutic challenge for both the radiologist and the surgeon than the palpable undescended testis. Many diagnostic modalities are used for localization of the impalpable undescended testis as Ultrasonography, computed tomography scan, magnetic resonance imaging and testicular angiography. There are many factors that should be taken into consideration with the use of any diagnostic technique as: the accuracy of each technique compared to the other, the invasiveness of the technique, the amount of radiation exposure, the availability and finally the costs. The recent surge of laparoscopic surgery encouraged surgeons to use laparoscopy for both the diagnosis and treatment of impalpable testes as an alternative to open surgery with minimal morbidity, short hospital stay and better cosmetic outcome. The aim of this work is to study the value and accuracy of various available modalities for diagnosis of impalpable undescended testis. 24 patients with clinically impalpable undescended testes were included in the study .the mean age of patients is 3.6 years. All patients were subjected to careful clinical examination then Ultrasonography, multislice C.T and MRI then lastly laparoscopy. Ultrasonography detected only 7 cases (29.1%) and C.T examination detected 14 cases (58.3%) but MRI detected 15cases (62.5%). Diagnostic laparoscopy localized successfully 16 cases only, 7 cases intracanalicular and 9 cases intraabdominal. MRI was the most sensitive diagnostic modality in our study with sensitivity rate 77 % and specificity 82 %. |