Undescended Testis

Undescended Testis (Maldescensus Testis): Medical History

Medical history (history of the patient) represents an important component in the diagnosis of undescended testis. Family history Is there a frequent occurrence of undescended testis in male children in your family? Social history Current medical history/systemic history (somatic and psychological complaints). What symptoms have you noticed? Can you palpate a testicle in the testicular … Undescended Testis (Maldescensus Testis): Medical History

Undescended Testis (Maldescensus Testis): Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Sliding testis (retentio testis prescrotalis; gliding testis). Testicular ectopy Pendulum testis (“retractile testis”) Retentio testis inguinalis (inguinal testis; retentio testis inguinalis; “cryptorchidism“). Retention testis abdominalis (abdominal testis; Retentio testis abdominalis; “cryptorchidism“).

Undescended Testis (Maldescensus Testis): Complications

The following are the most important diseases or complications that can be caused by undescended testis: Neoplasms – Tumor diseases (C00-D48). Malignant (malignant) testicular tumors. Orchidopexy (surgical fixation of the testis in the scrotum) before age 13: risk was increased by 2.2-fold, then by 5.4-fold compared with the normal Swedish population. Genitourinary system (kidneys, urinary … Undescended Testis (Maldescensus Testis): Complications

Undescended Testis (Maldescensus Testis): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection and palpation of abdomen (belly), inguinal region (groin region), etc. (tenderness?, tapping pain?, release pain?, coughing pain?, guarding pain?, hernial orifices?, kidney bearing tapping pain?) Inspection and palpation of the … Undescended Testis (Maldescensus Testis): Examination

Undescended Testis (Maldescensus Testis): Test and Diagnosis

Usually, laboratory diagnostics can be omitted. However, laboratory diagnostics are obligatory (indispensable) in case of bilateral nonpalpable testis! 1st order laboratory parameters – obligatory laboratory tests – in bilaterally nonpalpable testes. Gonadotropins (LH, FSH – in suspected anorchia (absent testis). Inhibin-B (inhibin B is produced in the Sertoli cells of the male. It directly inhibits … Undescended Testis (Maldescensus Testis): Test and Diagnosis

Undescended Testis (Maldescensus Testis): Drug Therapy

Therapeutic target Prompt elimination of maldescensus testis. → The therapy should be completed by the end of the first year of life, because there may be damage to the germ cells due to later therapy! Therapy recommendations The first six months of life should be waited for spontaneous descent (“testicular descent”). After that, hormone therapy* … Undescended Testis (Maldescensus Testis): Drug Therapy

Undescended Testis (Maldescensus Testis): Diagnostic Tests

Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification. Abdominal ultrasonography (ultrasound examination of the abdominal organs) with a high-resolution transducer (> 7.5 MHz) – for examination or detection of the nonpalpable testis in the inguinal canal or abdomen and exclusion … Undescended Testis (Maldescensus Testis): Diagnostic Tests

Undescended Testis (Maldescensus Testis): Surgical Therapy

1st order For undescended testis, orchidopexy should be performed if hormone therapy fails by 12 months of age. Treatment regimen: testis palpable or testis not palpable. Testis (palpable) Operative measure palpable inguinal orchidopexy (see below). nonpalpable: + Testis near the inner inguinal ring. Laparoscopic or inguinal orchidopexy + testis > 2 cm from the internal … Undescended Testis (Maldescensus Testis): Surgical Therapy

Undescended Testis (Maldescensus Testis): Prevention

To prevent undescended testis, attention must be paid to reducing individual risk factors. Behavioral risk factors Consumption of stimulants Tobacco (smoking) Environmental pollution – intoxications (poisonings). Diethylstilbestrol (DES) Mono esters of pthalatesNote: Phthalates belong to the endocrine disruptors (synonym: xenohormones), which even in the smallest amounts can damage health by altering the hormonal system. Persistent … Undescended Testis (Maldescensus Testis): Prevention

Undescended Testis (Maldescensus Testis): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate undescended testis: Pathognomonic (evidencing a disease). On palpation, an empty testicular compartment is found (occurrence: right > left; bilateral in 20% of cases)). Note!It should be noted whether there are other morphologic abnormalities associated with undescended testis. These include, in addition to general signs of dysmorphia specifically other … Undescended Testis (Maldescensus Testis): Symptoms, Complaints, Signs

Undescended Testis (Maldescensus Testis): Causes

Pathogenesis (development of disease) The cause of cryptorchidism is multifactorial, and the involvement of various factors (descensus (“descent”) of the epididymis, gubernaculum testis, ligamentum diaphragmaticum, nervus genitofemoralis, processus vaginalis) is discussed. In most cases, it is seen as a result of intrauterine (“inside the uterus“) insufficiency (weakness) of the hypothalamic-pituitary-gonadal axis (diencephalic-pituitary-gonadal axis). It can … Undescended Testis (Maldescensus Testis): Causes