Rete testis dysgenesis. A characteristic lesion of undescended testes.

Abstract

To evaluate the status of the intratesticular spermatic duct system (rete testis, RT) in patients with cryptorchidism. We examined 40 surgical orchiectomy specimens from postpubertal patients with undescended testis from pathology files at La Paz Hospital, Madrid, Spain. Special attention was given to the intratesticular spermatic duct system, mainly the RT. In all cases, the RT was underdeveloped and was lined by columnar or large cuboidal cells (dysgenetic RT). According to the configuration of the mediastinal RT, the lesions were classified as diffuse hypoplastic RT (37.5%), hypoplastic-cystic RT (50%), or adenomatous pseudohyperplastic RT (12.5%). Although these changes could have resulted from incomplete pubertal maturation, many other data suggest that a primary abnormality of the RT is present. Important clinical considerations are derived from the fact that a functional obstruction of the sperm-conducting mechanism is determined by these abnormalities of the RT. The presence of intraluminal spermatozoa in epididymis and RT suggest that at least some of these patients are potentially fertile.