Testicular regression syndrome: Useful diagnostic approach

Introduction:Testicular regression syndrome (TRS) also known as “vanishing testis” is an entity characterized by subsequent atrophy and disappearance in fetal life of a primarily normal testis. It has an incidence of 35% to 60% in patients with cryptorchidism. Diagnostic controversies exist regarding approach to absence of testis. Aim of the study is to provide an approach helpful for diagnosis of testicular regression syndrome. Materials & Methods:Cases with TRS were selected among all undescended testes operated during a period of 7 years from 2007 to 2013. Diagnostic criteria include vascularized fibrous nodule with paratesticular element(s) in proximity. Results:Out of 19 TRS cases, 15 were from prepubertal and 4 from postpubertal group. Combination of paratesticular structures were noted grossly. The characteristic microscopic features include residual testicular parenchyma, nodular or discrete vascular fibrosis, dystrophic calcification, and hemosiderin deposition. Conclusion: TRS constitute the major bulk in prepubertal cryptorchid patients. Microscopic features of TRS have to be correlated with intra-operative findings before rendering a diagnosis. It can help pathologist as well as surgeon to solve problems related to absent testis/ no testicular parenchyma.