2017, Number 5
Rev Mex Urol 2017; 77 (5)
Padilla-Piña J, García-Vásquez RA, López-Chente CJ, Arriaga-Aguilar J, Zárate-Morales Á, García De León-Gómez JM
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ABSTRACTBackground: Testicular regression syndrome, or vanishing testis, is an alteration caused by the atrophy and disappearance of a healthy testis during the fetal period. Anatomically, it is characterized by a spermatic cord with no macroscopically identifiable testicular tissue. The absence of a testis in a 46XY male is usually unilateral and is the result of torsion or of intrauterine or perinatal infarction.
Clinic case: A 30-month-old male child, product of a second pregnancy, was evaluated for left cryptorchidism. Physical examination revealed genitals in accordance with age and sex, good gonadal development, a normal penis and prepuce, a right testis of approximately 12 mm in the scrotal sac, and a nonpalpable left testis. Inguinoscrotal ultrasound image showed an empty left scrotal sac and identified no left testis. A magnetic resonance study showed only a right testis in the scrotum. Diagnostic laparoscopy revealed a normal vas deferens tract in the right inguinal area, as well as good caliber gonadal vessels in the inguinal ring. A blind-ending vas deferens was found on the left side, along with absent gonadal vessels, and a closed inguinal ring.
Conclusions: Laparoscopy is the diagnostic study of choice for nonpalpable testis, given that it provides better access to the abdominal cavity and greater visibility, along with faster postoperative recovery in both children and adults.