Nonneoplastic Diseases of the Testis

Changes in our understanding of pathology have accelerated in recent years. The ability to approach a diagnostic problem from different points of view—clinical, morphologic, and molecular genetic—has led to an integrative approach to pathology. Nontumoral pathology of the testis has not been an exception. In this chapter, we start from a histophysiologic base that includes the development of the testicle, the descent of the prepubertal testis, and the adult testicle. The chapter continues with congenital anomalies of the testis and the alterations in sexual development, the classifications for which have not been uniformly accepted by those who study these matters. We focus on the undescended testis, a source of controversy regarding its best treatment—surgical versus hormonal. The problem of the infertile patient is addressed, bearing in mind not only the primary alterations, be these chromosomal or molecular, but also considering that efficient testicular function is only acquired when there is a harmonious interaction between different glands and organs. Vascular pathology of the testis is always interesting, whether focusing on a dramatic situation such as testicular torsion, or considering the relationship between varicocele and infertility. In the section on Inflammation and Infection, besides the classical processes, other lesser known processes are included in the section Other Testicular and Epidydima Lesions. Compared with the previous edition, this chapter incorporates a significant number of figures that properly document the text.