Biography
Biography: Amin Gohary
Abstract
Cryptorchidism is a common congenital anomaly of newborns that may resolve, persist or first appear in later childhood. It affects 4% to 5% of full-term and in 9% to 30% of premature males at birth. The testis can be found in any position along its usual line of descent; however, approximately 80% will be located in the inguinal region, just outside the inguinal canal. Approximately 20% of undescended testes are nonpalpable and in 20% to 50% of children with nonpalpable testis, the testis is absent. Laparoscopy has been established as the most reliable diagnostic modality for the management of impalpable testes. In experienced hands, laparoscopy is capable of providing nearly 100% accuracy in the diagnosis of the intra-abdominal testis with minimal morbidity. It clearly demonstrates the anatomy and provides visual information upon which a definitive decision can be made. Both internal rings can be inspected; the location and size of the testes, their blood supply and the nature, course and termination of the vas and epididymis can be determined. All of these anatomical landmarks individually or collectively have bearing on the operative management of the impalpable testes. In this presentation we will discuss the phenomena of absent testes in the light of recent discovery of a subgroup of testes that failed to descend from it is embryological subrenal position and likely to be labelled as an absent testis unless one is aware of the complexity of testicular development and descent.