Purpose: Laparoscopic assessment of pelvic anatomy has gained wide popularity over the years. Today surgical treatment of impalpable testis is nearly always preceded by diagnostic laparoscopy. The actual role of such a procedure remains undefined. We performed a prospective randomized clinical trial in patients with impalpable testis to evaluate the clinical usefulness of laparoscopy before surgical exploration. Materials and Methods: We studied pediatric, age matched patients with impalpable testis who were randomized to group 1 - 30 who underwent open surgery only and group 2 - 31 who underwent laparoscopy and open surgery. Anatomical findings, operative procedures, operative time and cost, number of recurrences and testicular volume at followup were then compared in the 2 groups. Results: There were no statistically significant differences in the 2 groups for any of the considered parameters except operative cost and time, which were significantly higher in the laparoscopy group. Conclusions: Preoperative laparoscopy does not provide any significant advantage over open surgery for treating impalpable testis.
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