Testicle Evanescent in Pediatric Urology: Laparoscopic Management

Abstract

Testicular regression syndrome or evanescent testis is a clinical condition that arises from atrophy and disappearance of normal testis in the fetal period. Anatomically it is characterized by a spermatic cord with no identifiable macroscopically testicular tissue. The absence of a testicle in a man 46XY is usually unilateral and arises from a twist or an intrauterine or perinatal stroke. The clinical case of male 2 years 6 months old, a product of the second pregnancy, which comes to evaluation, is presented cryptorchidism left. On physical examination, genital according to age and sex, good gonadal development, normal penis and foreskin, right testicle in scrotal sac, about 12 mm, left no palpable. It inguino-escrotal ultrasound with left empty scrotal sac, no left testicle, right scrotal sac with normal testicle is identified. MRI was performed showing only right testicle in the scrotum. Diagnostic laparoscopy was performed, finding in the groin area on the right side the path of vas deferens normally and gonadal vessels of good caliber in the inguinal ring, on the left side, vas deferens was found dead-end and absence of gonadal vessels and the inguinal ring closed. Laparoscopy is the most effective and most widely accepted for non-palpable testicle therapeutic diagnostic method because it provides access to the abdominal cavity and high visibility, with the known advantages of laparoscopy in terms of postoperative recovery, also applicable to pediatric patients.