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PEDIATRICS Vol. 110 No. 4 October 2002, pp. 748-751

Ultrasonography Is Unnecessary in Evaluating Boys With a Nonpalpable Testis

Jack S. Elder, MD

From the Division of Pediatric Urology, Rainbow Babies and Children’s Hospital, Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio

--> Objective. An inguinal sonogram often is obtained in boys with a nonpalpable testis to "localize" the testis, ie, determine whether the testis is present. The results of ultrasonography in boys with a nonpalpable testis were analyzed.

Methods. The records of boys who were referred to a pediatric urology center with a diagnosis of nonpalpable testis and who had undergone inguinal sonography were reviewed. The results of sonography were compared with findings in the office as well as surgical findings.

Results. A total of 62 boys who were referred with a diagnosis of a nonpalpable testis and who had undergone a sonogram were reviewed. The sonogram was ordered by the primary care physician in 51 boys (82%) and by a general urologist in 11 cases (18%). The testis was identified by sonography in 12 (18%) of 66 cases, and all were localized to the inguinal canal. Physical examination by a pediatric urologist showed that 6 were in the scrotum and 6 were in the inguinal canal or perineum. Of the 54 testes that were not localized by the sonogram, 33 (61%) were palpable and 21 (39%) were nonpalpable. Of the truly nonpalpable testes, laparoscopy and abdominal/inguinal exploration identified the testis as abdominal in 10 cases and atrophic secondary to spermatic cord torsion in 11 cases.

Conclusion. Sonography is unnecessary in boys with a nonpalpable testis, because it rarely if ever localizes a true nonpalpable testis, and it does not alter the surgical approach in these patients.

Key Words: testis • undescended • ultrasonography • testis • nonpalpable • radiology

Abbreviations: CT, computerized tomography • MRI, magnetic resonance imaging

Received for publication Oct 22, 2001; Accepted Mar 25, 2002.