Testicular atrophy - unilateral

Case contributed by Mostafa Elfeky
Diagnosis almost certain


History of painful right testis, was managed as orchitis since 3 years. The patient experienced progressive decreased right testicular size since then. Now complains of subfertility and unfeeling of the right testis.

Patient Data

Age: 35 years
Gender: Male



Right hemiscrotum shows absence of right testis or its remnants. The right spermatic cord is seen till the right hemiscrotum.

Normal sonographic features of the left testis.



Absent right testis and epididymis. 

Normal left testis.

Normal spermatic cords bilaterally.

Case Discussion

Testicular atrophy has many etiologies. Regarding the patient history of painful right testis since 3 years, possibilities include testicular torsion or epididymo-orchitis. He denied history of trauma also. 

The spermatic cord is seen at the right side till the right hemiscrotum, but with no testicular remnants identified on US or MRI, excluding undescended testis, also he confirmed the presence of both testes since childhood.

The patient took medical treatment for testicular pain in his locality where no appropriate medical service available. Ultrasonography is mandatory in all cases of testicular pain especially children and young adults for the possibility of testicular torsion to be excluded.

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