{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T20:36:11Z","timestamp":1761510971467},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,3,9]],"date-time":"2013-03-09T00:00:00Z","timestamp":1362787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Many new tools for management of impalpable testes have emerged during the last few years, yet, not many studies have compared them to the traditional ways of managing this problem. This work aims to reiterate the importance of the physical examination under general anesthesia prior to the surgical procedure in order to decide the best surgical approach for patients with impalpable undescended testis, especially in developing countries where expensive investigations are at premium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>The study included boys who were treated consecutively and recorded prospectively from 2000 to 2010. Examination under anesthesia (EUA) was performed during the study period. Those in whom the testes were palpable underwent the standard orchiopexy procedure. In those boys where EUA failed to detect the testes, laparoscopy or extended inguinal exploration was carried out, and the testes were treated accordingly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On initial clinical evaluation at the outpatient clinic, 545 boys were recorded to have impalpable testes. Undescended testis was unilateral in 529 boys and bilateral in 16 boys. However, on examination under anesthesia only 189 (34.7 %) were impalpable. Among boys in whom the testes were palpable after EUA, 38 had small\u2010size testes, 18 had normal size, and the remaining 300 boys had a sac or cord\u2010like structure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Meticulous EUA facilitates the accurate diagnosis and planning of the surgical approach to patients with an impalpable testis and should remain part of the surgeon\u2019s skill set. It is an inexpensive initial evaluation tool that may help in saving hospital resources, especially in developing countries.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-1973-1","type":"journal-article","created":{"date-parts":[[2013,3,8]],"date-time":"2013-03-08T17:48:29Z","timestamp":1362764909000},"page":"1125-1129","source":"Crossref","is-referenced-by-count":6,"title":["Examination Under Anesthesia for Management of Impalpable Undescended Testis: A Traditional Technique Revisited"],"prefix":"10.1002","volume":"37","author":[{"given":"Ossama M.","family":"Zakaria","sequence":"first","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, College of Medicine King Faisal University Riyadh Kingdom of Saudi Arabia"},{"name":"Division of Pediatric Surgery, Departments of Surgery, Faculty of Medicine Ismailia Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emad","family":"Hokkam","sequence":"additional","affiliation":[{"name":"Division of 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College of Medicine Dammam University and KFHU Al\u2010Khobar Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameh A.","family":"Shehata","sequence":"additional","affiliation":[{"name":"Departments of Surgery, Faculty of Medicine Alexandria University Alexandria Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AbdulRahman S.","family":"AlMulhim","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine Dammam University and KFHU Al\u2010Khobar Kingdom of Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamed A.","family":"AlWadaani","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine Dammam University and KFHU Al\u2010Khobar Kingdom of Saudi 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