Introduction:

Undescended testis is the most common endocrinological disease in the male newborn period.

Absence of testis, intra abdominal testis , inguinal or intra abdominal vanishing testis ( named as the testicular regression syndrome in the pathology literature ) are reasons of non palpable testis .

Laparoscopy is widely used to distinguish among these conditions.

In case of testicular regression syndrome ( TRS) some paediatric surgeons recommended a groin exploration to identify and remove the testicular tissue remnant, but others did not accept this indication because they could not find testicular tissue in testicular remnants.

Purpose:

To raise the question about the controversy regarding the optimal management of the testicular remnant in cases of TRS.

Methods:

In 2017-2018, 14 laparoscopies for impalpable testis were performed, in our paediatric surgery department, and have concluded to: cord structures that are blind ending or testis completely absent (agenesis). We also performed a literature search for other reports of the management of the testicular remnant.

Results:

In 5 cases, intra-abdominal blind ending vas and vessels were observed and nine showed testicular agenesis. Surgical exploration is considered unnecessary. No testicular remnant was excised in children with impalpable testis.

Referring to literature, TRS theoretically carries a potential for malignant degeneration in the long term and therefore removal of any remnant is a common practice to eliminate this risk. However, no case series has reported germinal dysplasia or intratubular germ cell neoplasia in any of the specimens taken from these patients.

Conclusion:

The optimal management of the testicular remnants is controversial. Some authors recommend routine excision of remnants, whereas others believe that this is superfluous. A review of the current

Literature has not identified any report of testicular germ cell tumors which appear to arise from TRS.