What is cryptorchidism
Cryptorchidism - absence of one or both testicles in the scrotum.
Normally, the testicles descend
in the scrotum at the 9 th month of fetal development. Unfinished omission eggs
in infants in most cases eliminated in the first weeks of life of the child.
Up to 1 year independent omission testis observed more in 70% of children with cryptorchidism.
After 1 year, the possibility of independent movement of the testicles into the scrotum there
before the period of puberty.
The incidence of cryptorchidism - 10-20% of newborns.
What are the causes and manifestations of cryptorchidism
- Endocrine factors: hormonal imbalance in pregnant women, a violation
the function of the testes, thyroid, pituitary embryo can cause a delay
testicular descent into the scrotum (often with bilateral cryptorchidism).
- Mechanical factors: the narrowness of the inguinal canal; the absence of a tunnel in the scrotum;
shortening of the spermatic cord, the processus vaginalis of the peritoneum, vascular supply
testicle; hypoplasia guide bundles; peritoneal adhesions in the area
the inner hole of the inguinal canal, and others.
- Genetic aspects: in some cases, found the gene mutation GTD (306190,
Cryptorchidism can be one-way and two-way
False cryptorchidism (the so-called migrant egg): egg can under the influence
cold or physical loads migrate into the inguinal canal, and even into the abdominal
cavity. When warming and relaxing the muscles, it is returned to the scrotum
The most common injury after egg can move into the inguinal canal or abdominal
cavity. In other cases, testicular migration abdominal cavity promotes its
Manifestation of cryptorchidism:
- Underdevelopment, the asymmetry of the scrotum, the lack of one or both testicles in the scrotum.
- Complaints of aching pain in the groin or abdomen. When abdominal delay
testicular pain, usually joined only at puberty.
It may be aggravated by physical activity, delayed stool, sexual arousal.
Methods of research and treatment of cryptorchidism
Methods of investigation for suspected cryptorchidism:
- Magnetic resonance imaging
- Testicular scintigraphy - not only possible to determine the location and size of
eggs, but also its functional state
- Angiography: A study of the abdominal aorta to detect testicular artery
and superselective sensing internal testicular vein with performance
venography undescended testicle.
Treatment of cryptorchidism:
- The basic method - surgery. Surgical treatment - fixing
eggs, it is advisable to carry out at the age of 4-6 years. Operation is
downgrade eggs and fixing it to the scrotum. Adults without fail
perform plastic inguinal canal. After surgical treatment is shown watching
- Conservative treatment of cryptorchidism is aimed at improving the functional state
eggs and correction of endocrine disorders. Vitamin E regulates the biochemical
processes in the cells of testicular tissue, he was appointed a nursing mother - 200-300 mg / day, at the age of
older than 1 month - 5-10 mg / day for 1.5-2 months. Choriogonadotropin (stimulation of testicular cell function) - 250,500 or 1000
U according to the age of 1-3 times per week, per course of treatment - 16-18 injections. Not
used in clinically proven inguinal hernia after surgery
on the same side of the inguinal region, and also at the location vnemoshonochnom
testicles. At the first signs of premature puberty
should stop taking the drug; in this case, the symptoms usually disappear
for 4 weeks. Testosterone 10 mg every other day / m (on the course - 15-20 injections)
during puberty when overt symptoms of hypogonadism. Tireoidin - with excess nutrition, obesity (0,005 grams at age 5, 0.05 g -
15 years of age 1-2 p / day for 15-25 days). Dianabol - under reduced
power (1 to 3 mg of p / d 5 years of age, 1.2 to 5 mg P / day at 15
s within 20-30 days).
Complications and prognosis of cryptorchidism
Complications of cryptorchidism - testicular infringement, testicular torsion. The signs of these complications are
the sudden appearance of pain in the undescended testicle, swelling, in rare cases - increase in body temperature. To prevent egg destruction is urgently needed
surgery. Perhaps the development of infertility, particularly in bilateral
cryptorchidism (for the formation of sperm cells needed a lower temperature,
than body temperature), as well as the appearance of malignant testicular tumors.
with cryptorchidism improved after surgery. Infertility can be cured
80% of operated patients with unilateral and 30% bilateral cryptorchidism.
Many patients have a combination of cryptorchidism with inguinal hernia.