Lost and found testes: the importance of the hCG stimulation test and other testicular markers to confirm a surgical declaration of anorchia.
BACKGROUND
In patients with impalpable testes,laparoscopy or open surgery is considered conclusive in establishing the absence of testicular tissue.


METHODS
Retrospective chart review.


RESULTS
Over a 22-year period, 4 out of 82 patients with a diagnosis of bilateral anorchia by laparoscopy or laparotomy had persistent testicular tissue suggested by endocrine evaluations. The clue to the presence of testicular tissue was: (1) a pubertal rise in plasma testosterone (2 patients); (2) the presence of possible Müllerian structures and of a detectable plasma anti-Müllerian hormone (1 patient), and (3) the fact that one of the gonads had not been seen at surgery (1 patient who still had a testosterone response to hCG postoperatively). Testes were localized by venography (3 patients) and laparotomy (1 patient).


CONCLUSIONS
A surgical diagnosis of bilateral anorchia needs to be confirmed by hCG stimulation, gonadotropin levels, or other markers of testicular function.
Endocrinology Service, Department of Pediatrics, Sainte-Justine Hospital and Research Center, Université de Montréal, Montréal, Québec, Canada.
Rebecca
R
McEachern
Anne-Marie
AM
Houle
Laurent
L
Garel
Guy
G
Van Vliet
D054304:Anti-Mullerian Hormone; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D006063:Chorionic Gonadotropin; D003456:Cryptorchidism / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D005837:Genitalia, Male / Q000002:abnormalities; D006023:Glycoproteins / Q000097:blood; D006801:Humans; D010535:Laparoscopy; D008297:Male; D013735:Testicular Hormones / Q000097:blood; D013737:Testis / Q000002:abnormalities* / Q000601:surgery; D013739:Testosterone / Q000097:blood
D015415:Biomarkers; D006063:Chorionic Gonadotropin; D006023:Glycoproteins; D013735:Testicular Hormones; D013739:Testosterone; D054304:Anti-Mullerian Hormone