Cryptorchidism (2/3) – Undescended Testicle: Symptoms and Diagnostic Work-Up
- Cryptorchidism (1/3): Definition and Causes
- Cryptorchidism (2/3): Signs, Symptoms and Diagnostik Work-Up
- Cryptorchidism (3/3): Hormonal Treatment and Surgery
Signs and Symptoms of Cryptorchidism
- Missing testicle(s)
- incomplete descent or ectopic testicle(s)
- Hydrocele testis (open Proc. vaginalis)
- Inguinal hernia
Diagnostic Work-Up in Cryptorchidism
Palpation:
Palpation (search for a missing testis) should be done either in a relaxed supine position, while sitting (infants) or while standing (children). 80% of nondescended testes are palpable. For nonpalpable testes, 20% are missing, 30% are atrophic inguinal testes and 50% are abdominal testes.
Sonography:
Ultrasound is suitable for the location of the non-descended testes in the inguinal canal.
Laboratory tests:
Laboratory tests are particularly indicated for bilateral nonpalpable testes.
FSH:
An elevated FSH before puberty is a sign for bilateral missing testes.
HCG stimulation test:
An HCG stimulation test is indicated for bilateral nonpalpable testes: serum testosterone is measured before and 32 h after administration of 5000 IU HCG. An increase of testosterone proves the existence of dystopic testicle(s).
Inhibin:
Inhibin is a testicular peptide hormone, which can predict testicular damage. Experimental examination.
Diagnostic laparoscopy:
When laparoscopy is able to identify testicular vessels and ductus deferens at the deep inguinal ring, an abdominal testis is not possible and inguinal exposure of the non-descended testis is done. If blind-ending testicular vessels are identified, the blind end is removed. If no testicular vessels are identified, the path of descent up to the lower pol of the kidney has to be searched.
| Cryptorchidism | Index | Treatment Cryptorchidism |
Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
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References
- Hutson und Hasthorpe 2005 HUTSON, J. M. ; HASTHORPE, S.:
- Testicular descent and cryptorchidism: the state of the art in 2004.
In: J Pediatr Surg
40 (2005), Nr. 2, S. 297–302
- Kolon u.a. 2004 KOLON, T. F. ; PATEL, R. P. ; HUFF, D. S.:
- Cryptorchidism: diagnosis, treatment, and long-term prognosis.
In: Urol Clin North Am
31 (2004), Nr. 3, S. 469–80, viii-ix
- M. Ritzen, A. Bergh, R. Bjerknes, P. Christiansen, D. Cortes, S. E. Haugen, N. Jörgensen, C. Kollin, S. Lindahl, G. Läckgren, K. M. Main, A. Nordenskjöld, E. R.-D. Meyts, O. Söder, S. Taskinen, A. Thorsson, J. Thorup, J. Toppari, und H. Virtanen.
- Nordic consensus on treatment of undescended testes.
Acta Paediatr, 96 (5): 638–643, May 2007.
- A. V. Thorsson, P. Christiansen, und M. Ritzen.
- Efficacy and safety of hormonal treatment of cryptorchidism: current
state of the art.
Acta Paediatr, 96 (5): 628–630, May 2007.
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Dr. med. Dirk Manski
man...@urologielehrbuch.de