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Review
. 2017 Dec;198(6):1410-1417.
doi: 10.1016/j.juro.2017.04.079. Epub 2017 Apr 21.

The Nonpalpable Testis: A Narrative Review

Courtney L Shepard  1 , Kate H Kraft  2
Affiliations
Review

The Nonpalpable Testis: A Narrative Review

Courtney L Shepard et al. J Urol. 2017 Dec.

Abstract

Purpose: While the nonpalpable testis represents a small portion of all cryptorchid testes, it remains a clinical challenge for pediatric urologists. Controversy exists surrounding the best evaluation and management of this entity. In this review we update what is known about the nonpalpable testis, including the etiology, preoperative evaluation and best surgical management as well as novel techniques and ongoing controversies.

Materials and methods: We searched PubMed® and MEDLINE® from January 2000 to January 2017 using relevant key terms. Of 367 articles 115 were considered for inclusion based on a priori design. Using a narrative review format, an update on the evaluation and management of the nonpalpable testis including novel concepts and techniques was synthesized.

Results: The nonpalpable testis should be evaluated by physical examination only. Imaging is not indicated for routine cases. The optimal surgical approach and technique remain debatable but several novel techniques have been described. Due to the rarity of the nonpalpable testis, randomized controlled trials and other quality comparisons are difficult. Therefore, management remains controversial.

Conclusions: Evaluation and management of the nonpalpable testis remain difficult, and some aspects are still debated. Future research should focus on multi-institutional collaborative trials to determine the optimal operative management.

Keywords: cryptorchidism; laparoscopy; orchiopexy; testis.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

Figure 1
Figure 1
Flow-diagram for study selection.
See this image and copyright information in PMC

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References

Appendix B

Additional Recommended References
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