A syndrome of non-palpable testis: history and current state of art. Literature Review

By to the domestic and foreign literature, non-palpable testes are found in 20% of cases among children with cryptorchidism. Approximately 50% of them are located in the abdominal cavity and 50% are atrophied or vanished ones. Purpose: To systematize data of the scientific literature on the syndrome of non-palpable testes in children. For the review, original articles found in the scientific source engines, such as eLibrary, PubMed, and Scopus, were used. Most often, literature sources divide non-palpable testes into three types: intra-abdominal, extra-abdominal, and non-viable. Extra-abdominal gonads are often of the normal volume, unlike intra-abdominal gonads which are mostly hypoplastic. Testicular ectopia is one of the variants of non-palpable testes when a testis cannot be detected on the usual migration path from the abdominal cavity. In children with cryptorchidism, testicular ectopia is observed only in 5% of cases, thus making it a rare case which poses certain challenges in diagnostics. There are many controversial issues regarding diagnostic methods and treatment strategies for different types of non-palpable testes in children. Most researchers recommend to use additional visualization options such as ultrasound, computed tomography, magnetic resonance imaging, and laparoscopy to confirm the presence or absence of the gonad. However, a definitive diagnosis is not always possible when based solely on ultrasound findings, as this method has limited sensitivity and specificity in detecting non-palpable gonads. The current publications state that an intra-abdominal testis can be visualized during diagnostic laparoscopy in 49% of case in boys with the non-palpable testicular syndrome and with no gonad found at ultrasound examination. Management of non-palpable testes in children, especially with high intra-abdominal gonad location, remains a highly relevant issue and requires further researches and observations.