Testicular deformities
Introduction
Introduction to testicular malformation Testicular malformations are male congenital developmental disorders or testicular lesions caused by many factors of acquired disease, which can lead to infertility. Specific testicular malformations are mostly caused by epididymal tuberculosis invading the testes, which is very rare. Common in clinical practice are non-specific testicular malformations and mumps-induced testicular malformitis, which is one of the common causes of male infertility. basic knowledge The proportion of illness: 0.001% Susceptible people: good for men Mode of infection: non-infectious Complications: Epididymitis orchitis varicocele
Cause
Causes of testicular malformation
1, endocrine abnormalities, endocrine if abnormalities, such as gonadotropin hypothyroidism, as well as pituitary microadenomas, etc., affect the development of the gonads, resulting in this testicular hypoplasia.
2, genetic factors, is a chromosomal abnormality, such as Klinefelter syndrome, is primary small testicular disease or fine tubule dysplasia.
3, genetic factors, that is, chromosomal abnormalities, such as Klinefelter syndrome, is primary small testicular disease or spermatual dysplasia. Genetic factors, such as chromosomal abnormalities, such as Klinefelter syndrome, are primary small testicular disease or fine tubule dysplasia.
4, the infection factor, the most powerful is the viral orchitis caused by mumps in children, can cause testicular developmental disorders. Pay attention to men's health and start from the hour, don't cast a serious illness, sometimes it is irreparable.
5, trauma or surgical trauma, some people because of childhood or puberty, after adults, because of some damage in the testicular area, or because of some surgery, the resulting testicular damage can also cause testicular development Bad or shrinking, etc.
Prevention
Testicular malformation prevention
The foreskin is too long and the phimosis, the cavernous induration, the concealed penis, etc., should always pay attention to its changes. The foreskin is too long, the foreskin is narrow and the phimosis, which will cause smegma and urine to accumulate in the foreskin cavity, induce penile head dermatitis, produce purulent secretions and epidermal exfoliation, and severe cases may cause foreskin and penile head ulcers or stone formation. Causes urethral stricture and acute urinary retention. Severe penile stenosis will constrain the development of the penis and affect fertility. Repeated episodes of penile head dermatitis can also make patients feel restless and nervous. Middle-aged patients are prone to penile sclerosis, and easily develop into insidious penile fibrous cavernous plaques, losing normal elasticity and penile curvature. Once the erection is not only painful but also deformed, it affects normal sexual life and even causes impotence. When the penis is bent and deformed for more than one year or plaque calcification, it should be operated early.
Penile scrotum transposition, often complicated by hypospadias. Hypospadias is a common urethra and external genital malformation. Severe chromosomal examination and gonad examination are required. The urethra is reconstructed by surgery to obtain a complete external genitalia. The penis is twisted, that is, the penis head is off the midline, and severe patients are obstructed by sexual intercourse, sometimes causing the patient to be unable to urinate normally. It also affects the formation of a patient's health psychology and affects normal social activities.
Congenital testicular loss, or loss of testicles after trauma, testicular torsion, testicular tumor, prostate tumor, testicular atrophy, urethral disease, penile deformation, etc., can cause corresponding symptoms, have a serious impact on the patient's psychology, or cause fertility difficulties, or If you are in danger of life, you should heal in time and finally achieve: normal urination, ideal sexual life, satisfactory appearance, and healthy sexual psychology.
Complication
Testicular malformation complications Complications Epididymitis orchitis varicocele
Epididymitis: The epiphysis of the testis is surrounded by the epididymis. The sperm is temporarily stored here after production. Epididymitis, more common in people around the age of 30, mostly due to testicular malformation and bacterial infection, causing the bacteria into the epididymis through the vas deferens. It often occurs with posterior urethritis, prostatitis, seminal vesiculitis, etc. The site can be bilateral on one side, and the attack time can be urgent.
Orchitis: Caused by testicular malformation Epididymitis directly spread to the testicles, caused by bacteria. Acute oral orchitis in children is usually caused by mumps virus. Because severe orchitis loses its ability to grow, doctors use antibiotics in addition to painkillers; they also need to apply testicles cold. If the doctor is treated improperly in the acute phase, bacterial orchitis can form an abscess or evolve into chronic orchitis.
Varicocele: The incidence of varicocele accounts for 10% of the 30- to 40-year-old male. 90% of it will occur on the left side due to the accumulation of spermatic vein blood flow, which causes the venous plexus to dilate, distort and lengthen. The varicocele star will be caused by a kidney tumor. The reason that varicocele is worthy of attention is that it may be accompanied by testicular atrophy and spermatogenesis, leading to infertility.
Semen cyst: A benign cyst that occurs in the spermatozoa of the testis or epididymis. The swelling and swelling of the mass is mostly as large as a cube of sugar. People call it the third testicle. Fortunately, this is very rare. If you insist on eliminating those bumps, the doctor can remove the surgery for you. Avoid trauma to the testicles and scrotum. Have sex regularly and avoid long-term sexual impulses.
Symptom
Testicular malformation symptoms Common symptoms Testicular microtesticular hypoplasia Sexual malformation Testicular drooping without testicles
The testes secrete androgen, which stimulates spermatogenesis and the development of male sexual organs and accessory sexual characteristics. Therefore, whether it is congenital developmental disorders or many factors of acquired testicular lesions, can lead to infertility. The testis is the main sexual organ of males. Its function is to produce sperm, and sperm and egg combine to form new individuals, thus ensuring the continuity of human race.
1. Abnormal position
Testicular fusion. The testicles on both sides are integrated into the abdominal cavity or the scrotum, and are easily mistaken for cryptorchidism or simple testis. More combined with kidney deformities. Cryptorchidism. Ectopic testicles. Abnormal attachment of the testis and epididymis can cause sperm to pass through obstacles and cause infertility. The connection between the two is not good, it is easy to cause testicular torsion, and even tissue necrosis due to insufficiency of blood supply.
2. The size is abnormal
Testicles are less than normal due to hypoplasia, and many are not isolated symptoms. Testicular enlargement due to hyperplasia, such as testicular teratoma, congenital atrophy.
3. The number is abnormal
No testosterone. Rarely, testicular differentiation is incomplete due to some reasons of embryonic development, and the testicles are atrophied and degenerated. However, due to the existence of some interstitial cells, the patient may have male external genitalia and appearance. Pay attention to the identification of bilateral cryptorchidism. This disease is characterized by an increase in luteinizing hormone (LH) in the blood, and no increase in plasma testosterone levels after chorionic gonadotropin. Androgen should be given regularly after puberty. Otherwise, there will be a class of eunuch syndrome, which can be used for testicular transplantation, using siblings or allogeneic testicular transplantation. This disease is complicated by vas deferens and epididymis. Single testicle. Most do not require special treatment, the purpose of the surgical examination is to find cryptorchidism that may exist in the abdominal cavity to prevent cancer. More testicles. Refers to the appearance of 3 or more testes.
1. Male pseudohermaphroditism symptoms: It is a male, but only the testicles, the genitals show female sexual characteristics.
2. Cryptorchidism: The fetal testis stays in any abnormal position during the decline.
3. No testicular disease: testicular incomplete or complete absence.
4. Testicular inflammation: Some inflammation occurs in the testicles, such as enlargement, bleeding, and so on.
Examine
Examination of testicular malformations
Patients may have mild leukopenia during routine blood tests.
1. Doppler ultrasound examination of testicular blood flow reduction.
2. Radionuclide 99m(99mTc) testicular scan showed that the blood flow perfusion of the torsion testis was reduced, and it was a radioactive cold zone with a diagnostic accuracy of 94%. It is recognized as the most reliable auxiliary diagnostic measure.
3. Ultrasound examination and CT scan are helpful in determining whether the testicles are swollen, acute hydrocele, scrotal edema, incarceration, but not reliable in identifying testicular torsion and epididymal orchitis.
Diagnosis
Diagnosis and differentiation of testicular malformation
Testicular malformations are not uncommon and can occur from the newborn to the elderly, but the incidence is high in children and people aged 20-25. Testicular malformations may be removed due to testicular necrosis. Testicular malformation is a disease of orchitis caused by various pathogenic factors, which can be classified into non-specific, viral, fungal, spirochetic, parasitic, damaging, chemical, and the like.
Parotid malformation orchitis
Mumps is the most common cause of orchitis, and about 20% of mumps patients have orchitis. More common in late adolescence. The testicles are highly enlarged and purple-blue in the naked eye. When the testis was incised, the testicular tubules could not be squeezed out due to interstitial reaction and edema. Histology and vasodilation were observed by histological observation. A large number of inflammatory cells infiltrated, and the seminiferous tubules were denatured to varying degrees. When orchitis heals, the testicles become smaller and softer. The seminiferous tubules are severely atrophied, but the testicular interstitial cells are preserved, so the secretion of testosterone is not affected. Orchitis usually occurs 3 to 4 days after the occurrence of mumps. The sac is erythema and edema. One or both testicles are enlarged and highly tender, and even hydrocele can be seen. Generally, mumps lesions can be found. After symptomatic treatment for about 10 days, testicular swelling subsides. About 1/3 to 1/2 patients can observe testicular atrophy from 1 to 2 months after onset. Generally, unilateral testicular involvement does not affect fertility. According to statistics, about 30% of patients with orchitis caused by mumps irreversibly destroy sperm, and the testicles are highly atrophied. Such as bilateral infection, testicular atrophy, causing spermatogenesis infertility, but androgen function is generally normal.
Acute non-specific testicular malformation
Acute non-specific orchitis often occurs in patients with urethritis, cystitis, prostatitis, prostatic hyperplasia, and long-term indwelling catheters. Infections spread through the lymph or vas deferens to the epididymis causing epididymal orchitis. Common pathogens are Escherichia coli, Proteus, Staphylococcus and Pseudomonas aeruginosa. Bacteria can be spread to the testes via blood, causing simple orchitis. However, testicular blood supply is abundant and has strong resistance to infection, so this situation is rare. Pathologically, the gross observation is mainly testicular enlargement, congestion, and tension. A small abscess was seen when the testis was cut. Histology showed focal necrosis, connective tissue edema and granulocyte infiltration of lobular cells, inflammation, hemorrhage, necrosis of the seminiferous tubules, and severe testicular abscess and testicular infarction. Diagnosis is based on clinical high fever, chills, testicular swelling, scrotal redness, edema and other symptoms to confirm the diagnosis. Of course, attention should be paid to the identification of acute epididymitis, mumps orchitis, spermatic cord torsion, and incarceration. Early diagnosis and timely administration of antibiotics to remove the cause is an important means to protect good functions in the future. A small number of orchitis, after healing, due to fibrosis and damage to the seminiferous tubules, can cause testicular atrophy and affect fertility.
