GU- Cryptochidism Flashcards
(41 cards)
Types of cryptochordidm
absent
undescended
ectopic
Result of
chromosomal abnormalities
hormonal
anatomic factors
Palpable
Majority (80%) are undescended testes or ectopic testes
Retractile testes
also palpable, sometimes misdiagnosed as undescended
nonpalpable
(20%) can be intra-abdominal, inguinal, or absent testes
most common male anomaly
affects ___% term infants and
____% preterm infants
3-5% term
30% premies
Bilateral in ___ % of cases
30%
if bilateral nonpalpable testes or cryptorchid associated with hypospadeous at birth should be evaluated for
life-threatning intersex conditions such as congenital adrenal hyperplasia
differenciating retractile testes
may be noted in scrotum intermittantly especially after a wam bath
associated with an overactive cremasteric reflex
can be placed in scrotum on examination and will remain there for short time after release
if tests retract immediately after palpation they should be considered
undescended
if one testicle is absent
the other testicle may be larger than expected
position for exam
cross leg for child
nonpalpable testes may be atopic, found in
femoral or perineal region
scrotum presentation
flat or underdeveloped on affected side
what do you think of one larger than expeted testicle?
may represent absent or nonfunctioning testicle on opposite side.
testing for unilater or bilateral palpable testes
none
testing for bilateral or unilateral nonpalpable with associated phallic abnormality
karyotype
endocrine testing
radiographic studies
imaging
usually not necessary unless child is very obese
Which test differentiates between anorchia and undescended testes?
Human chorionic gonadotropin (hCG) stimulation test
How does the HCG stimulation test work?
By stimulating testosterone production in funcitioning testes, can also result in testicular descent
At what age is intervention considered?
6 months-1 year undescended
if you cannot feel testes anywhere in inguinal canal or is unilateral after 6 MONTHS REFER, the teste not in the scrotum can deteriorate
surgery can be done at 6 months old
Reasons for treatment
reduced fertility
risk of tumors
trauma, torsion, hernia
psych factors of body image
repair of associated defects such as ing hernia
risk of cancer
Repair does not decrease risk but allows for screening, testes when corrected can be palpated for exam and detection
in cryptorchid male 1 in 2000
highes in ages 17-25 years
40% in those with undiscended testicle
Orchiopexy
open surgery fixes testes in scrotum and may repair hernia
Can also be performed laproscopically
