LAPAROSCOPIC AND HISTOLOGIC EVALUATION OF THE INGUINAL VANISHING TESTIS

Objectives. Visual inspection of the spermatic cord vessels and vas de ferens during laparoscopy now frequently determines further treatment. We set out to explore the implications of atretic spermatic cord vess els and vas deferens entering the inguinal ring, a finding noted on la paroscopic examination in some patients with a nonpalpable testis, and that we refer to as the inguinal vanishing testis. Methods. We review ed our series of 35 patients with nonpalpable testes with regard to th e laparoscopic, surgical, and histopathologic findings of the involved gonadal structures. Results. We noted atretic vessels and vas deferen s entering the inguinal ring in 14 patients in this series. All 14 pat ients underwent open inguinal exploration. Histopathologic findings re vealed fibrosis and hemosiderin deposits alone in 13 patients. One spe cimen had a microscopic focus of residual seminiferous tubules, No spe cimen contained dysgenetic gonadal tissue. Conclusions. We submit that patients with inguinal vanishing testes do not need to undergo inguin al exploration to remove residual testicular tissue. Only rarely will viable seminiferous tubules be found, so the risk of malignant degener ation is remote. The histopathologic findings suggest that the inguina l vanishing testis occurs secondary to a vascular accident in utero or in the neonatal period. (C) 1998, Elsevier Science Inc. All rights re served.