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Non Fusion of Testis and Epididymis - A rare case report



Undescended testis is one of the most common congenital anomaly in pediatric urology.Hormonal impairment, an abnormal testicular structure or anatomic obstruction have been implicated in the aetiology of this anomaly. The             gubernaculums testis, derived from the embryonic                       mesenchyme, extends from the testis to the epididymis and into the scrotum. This relationship between gubernaculum and epididymis explains why undescended testis is often associated with epididymal abnormalities. We present here one such abnormality, complete non-fusion of the testis and epididymis in a case of cryptorchidism.

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Occasionally, the epididymis is descended and the testis is retained (Fig. 25-6E). Such separation of testis and epididymis usually results in blindly ending vasa efferentia dilated to form spermatoceles. The testis itself may or may not be normal. If the condition is bilateral, the patient will be sterile. This was exactly the clinical picture in our case, demonstrated in the Image 2E. A retrospective study conducted by the department of pediatric surgery, university children's hospital, Bern , Switzerland on patients with undescended testis between 1986 and 1993 stratifies them into 4 groups based on the degeree of testis-epididymis non fusion.

A total of 880 testes were eligible for review, of which 93% (815/880) had normal fusion, 3.6% (32/880) had epididymal head nonfusion, 2% (19/880) had epididymal tail nonfusion, and 1.6% (14/880) had complete nonfusion. Hence , complete non fusion of testis and epididymis is considered very rare


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