4yr boy absence of right testes, diagnostic laparoscopy done, a blind end vessel seen what to do next?
(A) Open laprotomy (B) Nothing to be done (C) Scrotal approach (D) Inguinal approach
(D) Ans. D. Inguinal approachCryptorchidism is the most common congenital abnormality of the genitourinary tract.Cryptorchidism means hidden testis.An absent testis may be due to agenesis or atrophy secondary to intrauterine vascular compromise also known as the "vanishing testis syndrome".Bilaterally absent testes is anorchia which is 10% cases.More common on Right Side.Complications of undescended testesTorsion can be seen in incomplete testicular descentSterility is seen in bilateral cases (especially intra-abdominal testes)Incomplete testicular descent predisposes to malignant disease; cancer is more common in an incompletely descended testes-orchidopexy may or may not diminish the risk.Atrophy of an inguinal testes before pubey may possibly be caused by recurrent minor trauma.In patients with a unilateral nonpalpable testis, a descended testis that is larger than expected suggests an atrophic undescended testis; confirmation requires surgical intervention typically diagnostic laparoscopy to seek an intra-abdominal testis or confirm testicular agenesis. However, scrotal or inguinal exploration is sometimes done if a testicular remnant distal to the internal inguinal ring is suspected.