L3: Undesecended Testes

Question 2

Def of Cryptochidism / Undescended Testis

Answer 2

Cryptorchid testes are testes not located normally in the scrotum.

Question 3

Epidemeology of Cryptochidism / Undescended Testis

Answer 3

Question 4

Etiology of Cryptochidism / Undescended Testis

Answer 4

• Undescended testis is caused by any anomaly of hormonal control or anatomical processes required for normal testicular aescent.

Question 5

Classification of Cryptochidism / Undescended Testis

Answer 5

Question 6

Classification of Cryptochidism / Undescended Testis

• Arrest in normal descent

Answer 6

Question 7

Classification of Cryptochidism / Undescended Testis

• arrest outside the normal line of descent

Answer 7

Question 8

Def of Retractile Testis

Answer 8

• Retractile testes are testes which retract out of scrotum on stimulation of sensory branch of genitofemoral nerve (stimulation of cremastric reflex)
• but then return to scrotum within 10-20 seconds.

Question 9

TTT of Retractile Testis

Answer 9

Diagnosis of Retractile Testis → No surgical treatment is required.

Question 10

Def of Ascending Testis

Answer 10

• Ascending testis is a testis that was in scrotum at birth/ 3 months of age but then reascends with progressive increase in size of boy.

Question 11

Causes of Ascending Testis

Answer 11

• It is caused by a persistence of an obliterated fibrous remnant of processus vaginalis) that hinders the normal process of growth & elongation of the spermatic cord with age.
• Testicular ascent may also be acquired by fibrosis resulting from previous groin operation (e.g: Inguinal hernia repair).

Question 12

Complications of Cryptochidism

Answer 12

Question 13

Complications of Cryptochidism

• Infertility

Answer 13

• Unilateral UDT → Fertility is eauivalent to that of the normal population (~90%).
• Bilateral UDT → paternity rates of 50-65% even if corrected early

Question 14

Complications of Cryptochidism

• Malignancy

Answer 14

• Risk in abdominal testes > Inguinal testes

Question 15

Complications of Cryptochidism

• Inguinal Hernia

Answer 15

(patent processus vaginalis)

Question 16

Complications of Cryptochidism

• testicular Torsion

Answer 16

• As the testis is not fixed to the scrotum and more mobile (especially when at superficial inguinal pouch)

Question 17

Complications of Cryptochidism

• Trauma

Answer 17

The testis is more liable to trauma at inguinal or abdominal position.

Question 18

Complications of Cryptochidism

• Psychological Effect

Answer 18

…

Question 19

Dx of Cryptochidism

Answer 19

Question 20

Dx of Cryptochidism

• Clinical Dx

Answer 20

Question 21

Dx of Cryptochidism

• INVx

Answer 21

Question 22

Dx of Cryptochidism

• Labs

Answer 22

Question 23

Dx of Cryptochidism

• Rad

Answer 23

Question 24

Dx of Cryptochidism

• Laparoscopy

Answer 24

current gold standard

Question 25

Management of **Cryptochidism**

Answer 25

- Hormonal TTT - Surgical TTT

Question 26

Management of **Cryptochidism** - Hormonal TTT

Answer 26

Question 27

Management of **Cryptochidism** - SE of Hormonal TTT

Answer 27

Question 28

Management of **Cryptochidism** - Is Hormonal TTT First Line?

Answer 28

Many surgeons do not consider the success rates high enough to be worth the trouble since surgery itself is usually simple and uncomplicated.

Question 29

Management of **Cryptochidism** - Surgical

Question 30

Surgical TTT of **Cryptochidism**

Question 31

Surgical TTT of **Cryptochidism** - Timing

Answer 31

Question 32

Surgical TTT of **Cryptochidism** - Benifits

Answer 32

Question 33

Surgical TTT of **Cryptochidism** - Principles

Answer 33

Question 34

Surgical TTT of **Cryptochidism** - Approaches

Answer 34