"Preoperative radiological evaluation was not recommended in the guidelines on NPT [4, 5]."

"USG is an easy to perform noninvasive tool with no risk of anesthesia and radiation; but it has low efficacy at diagnosis to detect the presence of the testis or the absence of an intra-abdominal testis and is dependent on who performs. However, USG may be helpful in obese children, in cases of suspected DSD, to identify Mullerian structures and for determination of the exact size of pathologic and contralateral testes [6]."

"For preoperative evaluation and diagnosis of unilateral NPT, physical examination is all needed, and no laboratory investigation is necessary. In unilateral NPT, compensatory hypertrophy of the contralateral testis may suggest testicular absence or atrophy. Monorchidism was observed in 95% of patients with a contralateral testis 2 cc or larger in the series of Belman and Rushton [3], but this sign is not specific and does not preclude surgical exploration. In cases of bilateral NPT or unilateral NPT accompanied by anomalies of genital region such as severe hypospadias or scrotal hyperpigmentation, disorders of sex development (DSD) should be considered in differential diagnosis, and further genetic and endocrinological evaluations are needed [4]."

A Laparoscopy to exclude intraabdominal testicle

B Transscrotal nubbinectomy

C Inguinal exploration and nubbinectomy

D Observation

E Treatment with b-HCG[/size]

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Orchiopexy for Left Undescended Testis ( One year old boy). By Dr Tamer Ashraf Wafa, PhD, MRCS

see in next post[/center]