Scrotal testis size in unilateral non-palpable cryptorchidism, what it can and cannot tell: study of a Middle Eastern population

Summary Background Predicting the fate of a unilateral non-palpable testis based on its scrotal counterpart has been recommended by some, yet disputed by others, and the question remains open. Objective To investigate the accuracy of contralateral testis hypertrophy in predicting the absence of a unilateral non-palpable testis in a Middle Eastern population. Study design This retrospective study included all patients referred to the present institution with unilateral non-palpable testis between June 2010 and August 2014, and who had undergone laparoscopy. The scrotal testis was examined by sonography for size and volume, and diagnostic laparoscopy was utilized to determine the state of the cryptorchid testis. Results Of the 135 referred patients, 64 were aged ≤8 years, 29 were 9–18 years, and 42 were >18 years. Diagnostic laparoscopy revealed 63 intra-abdominal testes, 20 small intra-inguinal testes, 32 vanished testes, and 20 nubbins or aplasia. Scrotal testis volume was only a modest predictor for absence of the contralateral gonad in adult patients in whom a 22 ml cut-off yielded 64.3% sensitivity and 92.9% specificity. For those aged