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  • Title: Clinical and histological significance of the testicular remnant found on inguinal exploration after diagnostic laparoscopy in the absence of a patent processus vaginalis.
    Author: Renzulli JF, Shetty R, Mangray S, Anderson KR, Weiss RM, Caldamone AA.
    Journal: J Urol; 2005 Oct; 174(4 Pt 2):1584-6; discussion 1586. PubMed ID: 16148657.
    Abstract:
    PURPOSE: We reviewed the histological findings of cord structures excised at inguinal exploration after diagnostic laparoscopy in patients with a nonpalpable testis with the vas deferens and spermatic vessels exiting the internal inguinal ring in the absence of a patent processus vaginalis. MATERIALS AND METHODS: A retrospective review of 809 laparoscopic explorations for nonpalpable testes between 1981 and 2003 was conducted. The histological findings of the excised remnants of those patients with a closed processus vaginalis were reviewed. RESULTS: A total of 110 patients underwent excision of a testicular remnant at inguinal exploration in association with a closed processus vaginalis. Of the specimens 31 (28%) were on the right side and 79 (72%) were on the left side. The incidence of viable germ cell elements was 8 of 110 (7%). The presence of hemosiderin, calcification and fibrosis was identified in all 8 remnants with viable germ cell elements. CONCLUSIONS: The incidence of viable germ cell elements in the excised remnant when the vas deferens and spermatic vessels are identified exiting a closed internal ring in patients with a nonpalpable testis is 7%. To our knowledge no prior study has evaluated the incidence of viable germ cell elements in remnants associated with a closed internal inguinal ring. Based on these findings, we advocate inguinal exploration and excision of testicular remnants in these patients.
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