Cryptorchidism is a frequent diagnosis in pediatric urology and a well-known risk for male infertility and testicular malignancy. About 20% of undescended testicles are not palpable. Although the mean age of children presented for therapy with cryptorchidism is above 3 years, the ideal time-point for effective preservation of fertility is between 12 and 24 months of life. Laparoscopy has evolved in the past years as the method of choice for the diagnosis and treatment of non-palpable testes. Clear advantages of laparoscopy with regard to specificity and sensitivity have been shown compared to ultra-sonography and magnetic resonance imaging in detecting intra-abdominal testes. The purposes of laparoscopy for non-palpable testes are (a) localization and evaluation of the missing testis, (b) orchiopexy (one- or two-stage procedure) and (c) orchiectomy (if indicated), each selected alone or in combination for the individual case.
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