Introduction: Laparoscopy has been widely used in the diagnosis and treatment of IMPALPABLE TESTISES. This study was done to report the first experience the use of laparoscopy in IMPALPABLE TESTISES in the mashhad university of medical sciences (MUMS).Material and method: during 6 years, 43 patients with UDT were treated. In those were no evidence of existence of gonad in physical examination and ultrasonography, laparoscopy was done by the 5mm(0deg) lens. Position of testis, complications of operation and duration of admission in hospital was recorded.Results: In the 13 patients from 43 patients (30.23%) testise was not palpable in the inguinal canal. Also ultrasonography didn't detect the existence of testis, Therfore, laparoscopy was used. Average age of patients was 11.88±8.38 years. In 3 patients small remnant of testis was seen. Two patients had no testis. In 8 patients, normal gonads were seen that the treatment was done. No severe or mild complication was seen. All of the patients except on were discharged 24 hours after operation.Conclusion: Our study showed that laparoscopy is a benefit and safe instrument for correct diagnosis in IMPALPABLE TESTISES and in some situation prevents from a unnecessary exploration of inguinal region and laparotomy. Also in patients that previous exploration was not benefit for them causes a correct diagnosis.

Background: Metronidazole is an antibacterial medicine which is used for many years. This study was designed in Zanjan from 2001-2002 to detect side effects of this medication on spermatogenesis and testicular functions. Material and Methods: This experimental study was conducted on 24 male wistar rats which were divided into three groups: The control group who were receiving only pure water for 60 days; two experimental groups receiving 200 and 400 mg/kg/day Metronidazole for 60 days. Then the TESTISES of the rats were extruded and fixed in 10% Formalin and stained with Hematoxilin-Eosin methods. Results: The weight of the TESTISES and also the number of germinal cells were reduced significantly in the experimental groups (P<0.001). Reduction in the number of leydig cells were significant only in the rats which received 400 mg/kg Metronidazole per day (P<0.001). The changes in the number of sertoli cells were not significant in all groups. Conclusions: Metronidazole may affect testicular tissue and reduce its function. Thus, it is recommended to be used cautiously, especially in males.

Background: Preoperative marking of IMPALPABLE breast lesions is crucial for limiting false negative results and reducing the size of the resected breast tissue, thus improving cosmesis. The aim of this study was to evaluate wire localization versus intralesional methylene blue marking for surgical excision of IMPALPABLE breast lesions regarding the success of localization, cost, and limitations of both techniques.Method: This prospective cohort study included 50 patients with IMPALPABLE breast lesions or an area of suspicious microcalcification who were scheduled for surgical excision in the period between June 2020 and December 2021. Patients were randomly allocated into two groups: group I included 25 patients for surgical excision after preoperative ultrasound-guided methylene blue marking. Group II included 25 patients scheduled for surgical excision after preoperative guide wire localization under radiological guidance.Results: Localization by methylene blue injection has been associated with significantly shorter time of operation with mean duration (P = 0.018) and much reduced cost in comparison with guide wire (P < 0.001). Postoperative pain, reactions, ecchymosis, accuracy of localization, margin status, and patient satisfaction did not vary significantly between both groups.Conclusion: Localization by methylene blue injection is not only equally successful to guide wire in locating and identifying IMPALPABLE breast lesions for surgical excision, but also is significantly less costly and associated with a shorter duration of operation.

Background: Non-palpable undescended testis (NUDT) is one of the problems encountered in pediatric surgery. As studies show, about 30-40 % of NUDT is associated with intraabdominal testis (IAT), in the case of IAT various surgical techniques have been presented for example multistage orchiopexy, orchiopexy by microvascular anastomosis, orchiopexy by transaction of spermatic vessels at two stages, hormonal manipulation, in which there is no definitive success and there are several associated complications. Orchiopexy in one stage by transaction of spermatic vessels of the base of vas artery is a suitable method.Methods: This study is descriptive and prospective and was performed in Bahrami and Tehran children hospital from 2000-2001 on intraabdominal undescended testes. The patients were followed for at least 2 years.Results: From 31 patients, 70.9% were over 4 years old, 93.5% were hospitalized over 3 days, and operation time in 64.5% was lower than 3 hours.The most common early complication was vomiting (16.1%) and the most common late complication was wound infection (6.5%). There was a %80/6 chance of testicular anomaly. In follow up period, there was no decreasing in testicular size.Conclusion: One stage orchiopexy by spermatic vessel transaction is a safe technique with high success rate and low complication rate with acceptable increase in operation time and hospital stay. Based on our experience, we recommend this technique for non-palpable undescended testis.

Introduction: Infertility and azoospermia are among the clinical presentations of males with IMPALPABLE testis. The management of non-palpable testis especially in adult patients remains controversial. Routine imaging methods like sonography, CTS and MRI are not sensitive enough to detect IMPALPABLE testes and have high false negative results. Therefore, it is necessary to perform laparoscopic examination in such patients. Although a few studies have reported benefits of laparoscopic examinations in the management of such cases, but it is still subject to many controversies showing the need for more investigations in this area. The aim of this study is to evaluate the role of laparoscopy in the diagnosis and treatment (mostly orchiectomy) of IMPALPABLE testis in azoospermic men.Materials & Methods: This is a case series study in which the files and laparoscopy movies of patients who had attended Avesina Infertility Clinic form February 2006 to October 2005 and had indication for laparoscopy were retrospectively analyzed. During the study twenty testicular units from 12 married patients with primary infertility and azoospermia were studied. After preliminary evaluations, informed consent for probable orchiectomy was taken from the patients. After preoperative preparations, diagnostic/surgical laparoscopies were performed. In cases of blind ending vessels or vanishing testes, the procedure was terminated. Orchiopexy or orchiectomy was performed based on testis size, distance from internal ring and patient’s age.Results: Twenty testicular units from 12 patients with unilateral or bilateral cryptorchidism were studied. The mean age of patients at the time of attendance and laparoscopy was 37 years (33-43). Eight patients presented bilateral non-palpable testes and four patients with palpable one-sided atrophic testis, two patients had natural descents and two had undergone postpubertal orchiopexy. From the 20 IMPALPABLE testes undergoing the procedure, 5 (25%) were absent, 3 vanishing testes and 2 previously done orchiectomies. 15 out of the 20 testes (60%) were located in intraabdominal cavity and were managed successfully by the means of laparoscopic orchiopexy or orchiectomy. No laparoscopy related complications occurred. All testicular biopsies from orchiopexy or orchiectomy were sent to a pathology laboratory. Three of the 15 biopsies were reported as atrophic testis, three as immature testis and 8 of them had germ cell aplasia.Conclusion: The data suggest that laparoscopy can be considered as a safe and effective method for the management of non-palpable testis in adults. The patients may experience less pain and benefit from better cosmetics, early discharge and rapid recovery.

Background and Objectives: Nasal bone hypoplasia is a rare hereditary disorder, which seems to be related to other anomalies. This disorder may clearly appear in the appearance of a person by increasing age, and in terms of nasal and psychological functions, which its manifestations are different depending on the severity of the disorder. Case Report: The case was a 36-year-old woman who was referred to Beheshti Hospital of Qom city in 2016 with a chief complaint of dissatisfaction of the shape her nose. The patient had no previous surgery internal diseases, and trauma of head and face. She had no respiratory complaints, sleep apnea, nasal congestion, or rhinorrhea, but she complaint of recurrent sinusitis in the past. In the examination, her nose was cartilaginous and nasal bone IMPALPABLE on both sides. This article discusses a case of nasal bone hypoplasia, which was repaired by temporalis muscle fascia in the operating room.