A Case of Cryptorchidism with Ipsilateral Congenital Unilateral Absence of the Vas Deferens and Contralateral Renal Agenesis

[A CASE OF CONGENITAL UNILATERAL ABSENCE OF THE VAS DEFERENS WITH SUSPECTED IPSILATERAL RENAL AGENESIS]

A 5-month-old boy was referred to our department to examine poor development of external genitalia. The patient was diagnosed with micropenis and bilateral impalpable testes, and testosterone replacement therapy was recommended. The testes remained impalpable at 14 months of age; therefore, laparoscopy was performed to explore intra-abdominal testes. The patient was incidentally diagnosed with congenital unilateral absence of the right vas deferens. A renal sonography performed after the operation revealed a high possibility of right renal agenesis. Congenital absence of the vas deferens is associated with a high probability of renal anomalies. It is, therefore, essential to pay careful attention to renal dysfunction.

Unilateral Renal and Spermatic Cord Agenesis Accompanying to the Ureteral Extraperitoneal Inguinal Herniation in An Infant

Ureteroinguinal herniation is a rare event, usually diagnosed during the surgical repair of inguinal hernias and most reported cases have occurred in obese men during the fifth and sixth decades of life. Here, we describe the first case of unilateral renal and spermatic cord agenesis accompanying to the ureteral inguinal herniation in an infant.

Gubernaculum Sparing Laparoscopic Orchiopexy in Cryptorchidism with Ipsilateral Congenital Absence of the Vas Deferens: Unique Outcome

Congenital absence of the vas deferens (CAVD) is an uncommon anomaly that occurs in up to 1% of the male population. It can be associated with various other anomalies, including cryptorchidism and renal anomalies, such as renal agenesis. We here present a case of cryptorchidism with ipsilateral congenital absence of the vas deferens and renal agenesis and used the Stephen-Fowler technique for Orchiopexy depending on gubernacular vessels. A 7-month-old boy was referred to our center with left grade 2 hydronephrosis, right renal agenesis, and right impalpable, undescended testis. Examination under anesthesia and laparoscopic exploration with staged Stephen-Fowler orchiopexy were performed. The patient was followed up at 3, 6, and 12 months and had an excellent outcome. Cryptorchidism with congenital ipsilateral absence of the vas deferens and renal agenesis is a rare diagnostic entity. Our case supports the suggested theory that the gubernacular vessels can increase the blood supply to the testis, although further studies are needed to confirm this hypothesis.