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WHAT IS THE OPTIMUM CUTOFF VALUE OF THE CONTRALATERAL TESTICULAR
SIZE BY ULTRASOUND (US) TO PREDICT ABSENT TESTIS IN BOYS WITH NON-
PALPABLE TESTIS (NPT)?
Mohamed ELSAWY
1
, Vipul GUPTA
1
, Waled FARHAT
2
and Abdulnasser ALSAID
3
1) Ibn Sina Hospital, Pediatric Urology, Farwanyia, KUWAIT - 2) Sick kids Hospital, Pediatric Urology, Torronto, CANADA
- 3) Ibn Sina Hospital, PEDIATIC UROLOGY, Farwanyia, KUWAIT
PURPOSE
To determine and investigate the accuracy of ultrasonographic optimal cut-off value of the contralateral testicular size
that predicts the absence of the unilateral NPT.
MATERIAL AND METHODS
A prospective study was conducted over 4 years (10/2010-9/2014) on cases with unilateral NPT and normal descended
contralateral testicle. All underwent preoperative US for measuring the contralateral testicular size (Length and volume).
Patients with testicles rendered palpable under anesthesia were excluded. All patients underwent laparoscopy.
Contralateral testicular size was compared to testicular size of an age matched control group and correlated to
laparoscopy outcome.
RESULTS
Analysis was completed on 250 cases. Mean age at operation was 1.7 years. During laparoscopy testicles were found
intra-abdominal in 112 boys and were absent in 138 (45 were vanished and 93 were nubbin), of those 138 the mean
contralateral testicular length and volume was 17.0 mm and 0.76 mL compared with 11.8 mm and 0.32 mL in the boys
with the testis present and 12.2 mm and 0.33 mL in the controls, respectively (P < .05). The positive predictive value,
sensitivity, and specificity for a cutoff value of 16 mm in length were 94.4%, 91.9%, and 93.3% while for a cutoff value
of 0.60 ml in volume were 92.1%, 94.6%, and 90%, respectively.
CONTRALATERAL TESTICULAR LENGTH LAPAROSCOPY FINDINGS OF NPT
Controls
Absent(138)
Present(112)
Below 16 mm
11(7.9%)
105(93.8%)
182(91%)
Equal/Above 16 mm
127(92.1%)
7(6.2%)
18(9%)
CONTRALATERAL TESTICULAR VOLUME LAPAROSCOPY FINDINGS OF NPT
Controls
Absent(138)
Present(112)
Below 0.6 ml
7(5.1%)
101(90.1%)
186(93%)
Equal/Above 0.6 ml
131(94.9%)
11(9.9%)
14(7%)
CONCLUSIONS
Ultrasonographic contralateral testicular size may be a useful predictor of laparoscopy outcome, it strongly indicates
absent testis at an optimal cutoff value of 16 mm length and 0.60 ml volume. Whenever available preoperatively, it
provides valuable information for parents counseling.