Laparoscopy for Undescended Testis

The spectrum of undescended testis includes all cases where the testis is not found in the scrotum in the normal position. Where it is not possible to feel the testis, 1/4 will be absent altogether, 1/4 will lie high in the abdomen and 1/2 will be in the groin area.

Problems associated with undescended testis include:

• reduced fertility
• reduced fertility
• cosmetic appearance
• risk of torsion and injury
• groin hernia

Fertility from the undescended testis is not recoverable after infancy but overall is likely to be normal with a normal opposite testis.

The risk of cancer is some 1% and this may not be altered by repositioning of the testis in the scrotum. Repositioning does however permit ready examination of the testis and earlier cancer detection. The risk of cancer declines with age.

Laparoscopy is accepted as the most accurate method of localising the undescended, impalpable testis. This approach has less pain, fewer problems and quicker recovery compared with open procedure, allowing earlier return to normal function. Scars are cosmetically better. However, it is more expensive, with longer operating times.

The aims of laparoscopy are to:

• establish the presence and position of the testis
• remove those testes that cannot be brought down into the scrotum
• position the testis in the scrotum to allow examination and for cosmetic reasons
• treat associated hernia
• preserve fertility

The procedure is performed under general anaesthetic, on a day-stay basis.

Although most cases proceed without particular difficulty and have excellent outcomes, surgical complications occur overall in 5% of patients. Those recognised as common or serious are listed below, but this does not include the rare and extraordinary. We try at all costs to avoid any adverse outcome.

This fact sheet complements the discussion during your consultation, which will apply your individual circumstances to the above facts.