Testicular venography as an accurate indicator of true cryptorchism

It may be impossible to detect a testis on physical examination because of testicular agenesis, testicular atrophy or an intra-abdominal location. When the condition is bilateral, hormonal studies are useful. Inability to locate the testicle at operation is not synonymous with testicular absence. The presence of a testicular vein excludes gonadal agenesis. Visualization of the pampiniform plexus indicates a formed testicle and accurately locates its anatomic site. Four patients with unilateral impalpable testes underwent testicular venography. General anesthesia was used for the first patient only. There were no complications related to the investigation. All four patients underwent exploratory operations that confirmed the testicular venographic findings. Three patients had unilateral testicular dysgenesis or atrophy; one patient had an intra-abdominal undescended testis. Testicular venography is a safe, practical diagnostic investigation in boys with true cryptorchism.