Cryptorchidism

Cryptorchidism is an anomaly prenatal development of the testicles, which to the moment of birth of the fruit of one or both testicles do not descend from retroperitoneal organs (kidneys) through the inguinal canal into the scrotum.


Delay (1) and ectopia (2 - 4) of the testis with cryptorchidism: 1 - intraabdominal; 2 - inguinal; 3 - pubic; 4 - thigh.

Cryptorchidism is the notion of the collective; includes the so-called delay of the testicle (retention) and ectopia. The retention is intraperitoneal (Fig., 1) and the groin. When ectopia (Fig., 2-4), unlike retention, egg comes out of the inguinal canal, but in the scrotum misses, deviating in the thigh, pubic hair, pubic or perineum (ectopia femoral, pubic, groin, perineum). When ectopia egg functionally more fulfilling than retention.
Cryptorchidism is found in adults in 0.2-0.4% of cases (M. A. Skvortsov), and the newborn up to 30% (H.E. Makarova). One of the reasons of cryptorchidism - violation of regulatory mechanisms in the period of embryo fetal development associated with dysfunction of its endocrine system.
Diagnosis: the missing testicle in the scrotum and by palpation is found under the skin hips, pubic or perineum. Intra-abdominal, and often inguinal retention determined only after laparotomy. If one or both of the testicles do not find it, they say, respectively, on monachisme or anarchisme. Pahovom the cryptorchidism is often accompanied by a congenital hernia.
Treatment. All patients with cryptorchidism to 5 years should be taken under special observation (possibly self-lowering not descended testicles). In the treatment of cryptorchidism used hormone therapy at the age of 6-10 years (for the purposes and under the supervision of a physician): injection of human chorionic gonadotropin by 500 UNITS, 2 times a week for 2 months and methyltestosterone 0,005 g 1 time per day for 1 month. Surgical treatment of cryptorchidism used after an unsuccessful therapy at the age of 6-10 years (at least in the period of puberty). The essence consists in the reduction of the testis and commit it into the scrotum. In most cases of cryptorchidism forecast is favorable.

Cryptorchidism. The process of subsidence of the testicles from the abdomen into the scrotum for the moment of birth of a child usually ends. The normal flow of this process can be broken on the basis of a common endocrine underdevelopment of the organism (in gipogenitalizme, distrophia adiposo-genitalis, miksedeme) or mechanical obstacles - inflammatory growths testicles narrow the inguinal canal or a short. spermatica interna. This anomaly is called cryptorchidism (kryptos - hidden). Cryptorchidism is unilateral and bilateral. Depending on the delay of the testis in the abdomen or in the inguinal canal distinguish abdominal and groin cryptorchidism.
The delay of the testicle is often temporary. In these cases, in the first years of life, up to 10-12 years, the egg is placed into the scrotum. In newborns cryptorchidism occurs in about 2%, and in adults 0.1% of the cases. The endocrine function of the detained retained testicles, spermatogenesis sometimes saved, often reduced or absent.
The delay of the testis in the abdomen usually does not manifest. Inguinal cryptorchidism causes pain caused by compression of the testis in case of physical stress, cough, walk. Often cryptorchidism is accompanied by a hernia.
Treatment of cryptorchidism surgical: reduction of the testicle into the scrotum and fixing it in this position.
Up to 10-12 years any surgical intervention for the reduction of testicular impractical because approximately 5/6 cases it is to this period yourself fall into the scrotum.
If the inguinal cryptorchidism, causing pain, reduction of the testicle into the scrotum fails due to short spermatic cord, the testis moves in preperitoneal tissue.
With abdominal cryptorchidism you can also resort to the reduction of the testis that improves the conditions of its development and has a preventive purpose, as detainees in the testicles much more often than in normal located, are developing malignancies. Indications for surgery relative.
In each case of cryptorchidism is advisable before the operation to use hormone therapy to help accelerate the growth and development of the testicle, which is conducive to lowering it into the scrotum. The course of treatment is best spent ages 6-12. Within 2-6 months impose gonadotropic hormone pituitary - proly And 100-200 units a day. The risk of premature ripening of the body eliminates the endocrine activity of the thymus.