cryptorchidism
Introduction
Introduction Cryptorchidism refers to the testicles not falling to the scrotum, including testicular insufficiency and testicular ectopic. The vast majority of clinical cryptorchidism is incomplete testicular decline. The ectopic testis is most often located in the superficial sulcus of the groin. 80% of cryptorchidism can be touched, 20% can not be touched, about 20% of the testis is not testicular loss, and 30% is testicular atrophy. Children can retract the testicles and usually only need to be followed up to prove that the testicles are in a normal state without retraction. In the diagnosis of bilateral non-testis, it is necessary to confirm the male karyotype, and it is necessary to conduct an endocrine assessment to help determine the presence of unilateral or bilateral testes.
Cause
Cause
Cryptorchidism is caused by abnormal testicular decline, which causes many abnormalities in testicular decline. Common ones are:
1. Introduce the testicle into the scrotum or the testicular lead is abnormal or missing, so that the testicle cannot be lowered from the original position to the scrotum.
2. Congenital testicular hypoplasia makes the testis insensitive to gonadotropin and loses its motility.
3. Luteinizing hormone-releasing hormone produced by the hypothalamus causes LH and follicle stimulating hormone FSH deficiency in the pituitary gland, which may also affect the motility of testicular decline. Most of the patients caused by endocrine factors are bilateral cryptorchidism, and other factors are mostly unilateral cryptorchidism, and sometimes cryptorchidism can be combined with inguinal hernia.
Examine
an examination
Related inspection
Laparoscopic male examination
1. Mainly for the inaccessible testicles, in order to determine the presence and location of the testis, B-ultrasound can be used as a routine preoperative examination.
2. CT, MRI has no advantage in the diagnosis of cryptorchidism relative to B-ultrasound. Testicular arteriovenography and spermatic venography are not recommended. There is no point in the radioactivity test of the testicles. In most cases, the choice of surgery, the surgical procedure, and the improvement of cryptorchidism do not depend on imaging results.
3. Laparoscopy is the "gold standard" for the diagnosis of cryptorchidism, which can be treated during positioning.
4. Bilateral or unilateral cryptorchidism with short penis, hypospadias, etc., need to carry out HCG stimulation test, androgen, FSH, LH, MIS / AMH determination, karyotype, genetic determination and other tests.
Diagnosis
Differential diagnosis
Should be differentiated from ectopic testes, retractable testes.
Retracted testes are more common in infants and young children due to excessive contraction of the cremaster muscle. As the age increases, testicular enlargement and cremaster muscles decrease, this phenomenon will gradually decrease. The retracted testicles are gently pushed down by hand and can be returned to the scrotum. After releasing the testicles, the testicles can stay in the scrotum for a period of time. The difference from the sliding testis is that after the latter is pushed into the scrotum, once the testicles are released, they return to their original position, which belongs to the cryptorchidism category.
The ectopic testicle can find the testicle above the pubic symphysis, the thigh or the perineum. When the normal testicles fall, in most cases, the scrotum branches along the end of the lead band enter the bottom of the scrotum, such as the testicles do not fall to the bottom of the scrotum, and other branches along the end of the testis lead down to the pubic bone, thighs or In the genitals, ectopic testes are formed. About 1% of cryptorchidism.
