Bülent ŞEN, Coşkun ŞAHİN, Cüneyt ADAYENER, İlker AKYOL, Gürer YAKUT, Ferhat ATEŞ

Ele gelmeyen testisli olgularda laparoskopi deneyimimiz: 111 olgunun retrospektif analizi

Son 11 yıl içerisinde, 2 ayrı üroloji kliniğinde, ele gelmeyen testislerde uygulanan laparoskopik girişimlerin sonuçlarının retrospektif analizinin yapılması. 1996-2007 yılları arasında, iki ayrı Üroloji Kliniğinde, ele gelmeyen testis nedeniyle laparoskopik girişim yapılan olguların dosyalan tarandı. Karşı testisi normal olan olgularda laparoskopik orşiektomi, bilateral olgularda laparoskopik bir veya iki seanslı orşiopeksi, birlikte hemi olan olgularda da laparoskopik orşiektomi ile birlikte laparoskopik herni onarımı uygulandı. Çalışmaya 111 olgu alındı. Ortalama yaş 23 (9-42) ve hastanede kalış süresi 1 (1-4) gündü. Ortalama operasyon zamanı ilk 15 olguda 60 (45-90) dakika, sonraki olgularda 20 (15-20) dakika idi. Hiçbir olguda transfüzyon gerektiren kanama, organ yaralanması oluşmadı. Dört olguda pneumopreperitoneum, 8 olguda ciltaltı amfızemi, 13 olguda diyafragmatik irritasyona bağlı omuz ağrısı gözlendi. Ele gelmeyen testisli olgularda laparoskopik girişim güvenli, etkin, kolay uygulanabilen, minimal invazif bir tanı ve tedavi yöntemdir.

Anahtar Kelimeler:

Kriptorşidizm, Genital hastalıklar, erkek, Laparoskopi, Testis hastalıkları, Geriyedönük çalışma, Yemek sonrası

Our laparoscopy experience in patients with non-palpable testicles: Retrospective anaysis of 111 cases

Retrospective analysis of the outcome of the laparoscopic interventions for nonpalpable testicles in 2 separate Urology Departments during the last 11 years was made. The charts of the patients who underwent laparoscopic interventions for nonpalpable testicles at two separate Urology Departments between July 1996 and February 2007 were reviewed. Laparoscopic orchiectomy was performed in patients with normally descended contralateral testicles. Laparoscopic 1 or 2-stage orchiopexy was performed in patients with bilateral nonpalpable testicles. Concomitant hernia repair was done following the orchiectomy whenever it was detected. In 46 cases with non-palpable testes, indirect hernia was also observed. A total of 111 cases were included. Mean age and hospital stay were 23 (9-42) and 1 (1-4) days respectively. Mean operative time was 60 minutes (45 to 90) and 20 minutes (15 to 20) for the first 15 cases and for the following cases respectively. No blood transfusion was needed, nor any organ injury was detected. Pneumoperitoneurn, cutaneous emphysema and shoulder pain due to diaphragmatic irritation were observed in 4, 8 and 13 cases respectively. Laparoscopy in nonpalpable testicles is a safe, effective, practical and minimal invasive method for both diagnosis and treatment.

Keywords:

Cryptorchidism, Genital Diseases, Male, Laparoscopy, Testicular Diseases, Retrospective Studies, Postprandial Period,

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