[Contribution to the clinical and intraoperative diagnosis of monorchism]

An exact diagnosis of a congenital absence of the testis (monorchism) may be a problem from the clinical (preoperatively) as well as from the surgical (intraoperatively) point of view. Namely, there has not yet been generally accepted clinical and surgical criteria which could contribute to a doubtless verification of this, not so rare, anomaly in children. After an analysis of their numerous patients, the authors conclude that compensatory hypertrophy of only one intrascrotal testis has been proved as a clinical indicator of a monorchism. Finding a normal inguinal canal without a hernia, spermatic blood vessels blindly ending and vas deferens like a cord during the surgery are reliable signs indicating that there is no testis and that further surgical exploration will not succeed in finding a testis. Even only an operative finding of blindly spermatic blood vessels is sufficient for a definite diagnosis of monorchism, but finding only blindly ending vas deferens or epididymis suggests that one should continue to search for the testis. The upper border of surgical exploration, with the aim to detect or exclude a monorchism, is situated at the lower pole of the kidney.