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

Ebtehal Althobaiti,Hattan Badr,Raghdah Alsharif,Maryam Aloqalaa,Naif Alqarni

doi:10.1155/2019/7408412

Abstract

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.

Highlights

Congenital absence of the vas deferens (CAVD) is an uncommon anomaly that occurs in only about 1% of the male population [1]
Since the development of the genital and renal systems are closely integrated, renal agenesis and other renal anomalies often coexist with CAVD, in about 30.2% of cases [2]
We here present a case of cryptorchidism with ipsilateral CAVD and renal agenesis and used the Stephen-Fowler technique for Orchiopexy depending on the gubernacular vessels, with an excellent outcome

Summary

Introduction

Congenital absence of the vas deferens (CAVD) is an uncommon anomaly that occurs in only about 1% of the male population [1]. The exact spectrum of causes is unknown, it involves a defect in the developmental process before the complete separation of the Wolffian duct (mesonephric duct) and ureteric bud during the 5th week of gestation [3]. Such anomalies are usually found incidentally in the evaluation of various conditions, including undescended testis, which is considered one of the most common congenital anomalies in boys [4]. We here present a case of cryptorchidism with ipsilateral CAVD and renal agenesis and used the Stephen-Fowler technique for Orchiopexy depending on the gubernacular vessels, with an excellent outcome

Case Presentation

Findings

Discussion

Conclusion