Elsevier

Urology

Volume 65, Issue 6, June 2005, Page 1226
Urology

Case report
Missed testis on laparoscopy despite blind-ending vessels and closed processus vaginalis

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Abstract

Laparoscopy has become a preferred technique to evaluate a nonpalpable testis. It gives excellent visualization of the anatomy to differentiate a viable or absent testis. We present a case of an intra-abdominal testis that was missed on diagnostic laparoscopy. Despite a closed processus vaginalis, an absent vas deferens, and blind-ending vessels above the internal ring, the testis was missed.

Section snippets

Case report

A 1-year-old boy with a left nonpalpable testis and an ipsilateral multicystic dysplastic pelvic kidney had a negative examination under anesthesia and scrotal exploration. Laparoscopy revealed a large left multicystic kidney. A closed internal ring, no evidence of a vas deferens, and distinct vessels ending blindly were noted (Fig. 1). These vessels originated from a cephalad source and traveled over the psoas muscle.

One year later, the kidney had grown by ultrasound measurement. Therefore,

Comment

This case reiterates the importance of a thorough examination during exploration of a nonpalpable testis. In this case, we missed the testis on both scrotal and laparoscopic exploration. When the processus vaginalis is closed, the testis is usually vanished or absent.1 We did not suspect an abdominal testis and we were deceived by the origin of the blind-ending vessels.

A similar case was reported by Zaccara et al.2 They explored a patient with a nonpalpable testis and an ipsilateral multicystic

References (3)

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