Complete testicular epididymal dissociation in the abdominal cryptorchid testis.

AIM: To document the incidence of complete testicular epididymal dissociation (CTED) in the cryptorchid testis and evaluate its operative outcome.

METHODS

The presence of CTED was noted prospectively in cases of undescended testis and the operative findings were studied.

RESULTS

CTED was encountered in 11 testes in 10 boys out of 29 intra-abdominal testes among the 142 undescended testes (8%) operated. Ages of patients varied from 18 months-14 years (median 4.5 years). All 11 testes were intra-abdominal. In 5 out of 11 testes, the dissociation was associated with a wide separation of the epididymis and testis. The dissociated epididymis was in the scrotum attached to the gubernaculum while the testis was intra-abdominal. One case had bilateral CTED. Successful subdartos orchidopexy was done for 8 testes, 6 after Prentiss maneuver. Two gonads were fixed just below the pubic tubercle. Orchiectomy was done in one case with a small sized testis with a short gonadal vessel.

CONCLUSION

CTED was encountered in 8% of cases of cryptorchidism. A palpable nubbin-like tissue in the scrotal sac in the presence of CTED may suggest a descended dissociated epididymis with an intra-abdominal testis. Successful subdartos orchidopexy was possible in 73% of testes with CTED.