Non-palpable Testis (Laparoscopy)

Laparoscopically possible findings in a clinically and in general anesthesia non-palpable testis. A. The testis may lie intraabdominally on a route between the lower pole of the kindney and the internal inguinal ring. The vas deferens which comes from a caudal direction joins the vessels of the spermatic cord that come from a cranial direction. B. Situation analogous to A. In addition to a dissociation of the testis and epididymis the testis or epididymis are alternatively missing, or they are hypo- or dysplastic. C. Situation analogous to A. However, one part of the vas deferens (on the left side in the picture) enters the inguinal channel, and the other part leaves the inguinal channel and reaches the epididymis. In A to C the diagnosis is abdominal retention of the testis, which means the descent is missing. The situation may be complicated in that an additional malformation may be present: In B an interruption of the connection between testis and epididymis (so-called testis-epididymis dissociation), and in C an abnormally long vas deferens (both malformations occur also in other types of cryptorchidism); or that the testis is hypo- or dysplastic, or is absent following an intrauterine or perinatal disturbance of blood supply. D and E. The diagnosis is canalicular retention of the testis; the testis is insufficiently recognizable at the internal inguinal ring or not visible at all, and the vas deferens as well as the vessels of the sprematic cord enter the inguinal channel. In E, also a anorchism is possible; in this case, the elements of the spermatic cord are ending within the inguinal channel.