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Undescended testis
One or two testicles aren't at an undescended testis in the scrotum. It is a congenital retardation. One also talks about cryptorchidism at an undescended testis, what as much as a hidden testicle means. Further technical term is Retentio testis. "Retardation of the testicle" is translated it.
The undescended testis happens with around 3% of the male newborn childs. Premature deliveries are more frequently concerned. There is an undescended testis at the end of the 1st year of life only still with 0.8% of all boys since the testicles walk into the scrotum, however, spontaneously certainly in the first life months.
The testicles of the male embryo usually already walk after below from the inguinal region at the beginning of the third pregnancy month. The testicles move finger more similarly evaginations of the peritoneum at this along twos. In the seventh pregnancy month they hike through, the inguinal canal they then should be palpable in the testicle at the birth.
The reason for the undescended testis cannot be determined in many cases obviously. With some boys anatomical obstacles are the cause: The testicle gets stuck in the inguinal canal on its walk from the abdominal cavity here. In some cases there also can be a disturbance of the hormonal feedback control. An insufficient secretion of the hormone gonadotropin then can be responsible for the undescended testis.
The clinical picture at an undescended testis appears as follows:
As mentioned already one is only or not the slightest testicle in the scrotum. This development disturbance at first doesn't cause any further troubles and isn't painful. One distinguishes coarsely three forms of the undescended testis:
- Abdomen testicle: The testicle lies in the abdominal cavity and therefore isn't palpable either.
- Inguinal testis: The testicle lies in the area of the inguinal canal and is palpable there, as a rule.
- Testicle ectopia: The testicle is in an atypical (ectopic) lie. It is outside the area in which it usually lies or hikes. This can be in the subcutis fatty tissue of the thigh or the perineum for example.
Special shapes are so-called pendulum and gliding testicles: The testicles are mobile in the area of their walk between the inguinal canal and the scrotum (Testis mobile).
A wandering testicle is a norm variant. The testicle normally lying in the scrotum climbs occasionally into the inguinal canal, however, glides back by himself again, too. This is for example the case at a cold stimulus. The scrotum contracts and the two testicles are drawn into the inguinal canal for a short time.
At a gliding testicle the testicle can be slid into the scrotum down, it glides but due to a too short vessel cord back after letting off into the inguinal canal again. This special shape is therefore in need of treatment.
The diagnosis, "undescended testis", is already immediately stated by a pediatrician at the newborn child examination (U1) after the birth. If the scrotum is empty, then the pediatrician feels the abdominal cavity and the last region of the small patient. At striking results the examination is already repeated in the third life month. Until this time the testicles often still walk into the scrotum by themselves.
The search for an atypically situated testicle can turn out difficult. Perhaps no testicle is palpable, a computed tomography an ultrasound scan must be carried out so. If with these examination methods the testicles aren't traceable, then a hormone test can clear whether testicles are developed at all.
The possible results of an undescended testis are the followings:
- Sterility: The right lie of the testicle in the scrotum is prerequisite for the normal maturation of the germ cells and with that for the later spermium formation. The spermium production is carried out optimally only at 35 º C. The temperature is only only just under the normal body temperature. It remains the testicle in the abdominal cavity too long, comes by the higher temperature ruling there to a damage done to the tissue forming spermiums. The longer the testicles stay inside body, the bigger the damage is. At a unilateral undescended testis is in 30% of the cases with sterility . both testicles are concerned, this even leads into 70% of the cases to sterility.
- Increased cancer risk: If the undescended testis isn't treated, then the patients have a risk increased by the fivefold later of falling ill with a malignant testicular tumor. In principle, applies to it: The more highly the testicles lie, all the bigger the risk is.
A treatment of the undescended testis should be started with until the conclusion of the first year of life so that the procreative capacity of the boy remains unchanged.
As a rule, an undescended testis is treated with hormones. This therapy shape is based on the remark that children have hormone levels (gonadotropin mirror) often degraded with cryptorchidism too. The hormonotherapy caused walks the testicle in 40 to 75% of the cases down one. There are two species of the therapy:
- The hormone GnRH is sprayed into the nose and taken about the mucosa there (gonadotropin-Releasing-hormone). The therapy time period is approximately four weeks. GnRH causes the release of LH in the pituitary gland which for his part influences the sexual organs.
- If the gift of GnRH doesn't lead to the desired success, a human chorionic gonadotrophin is given (to HCG) over a period of four weeks. This substance also has an effect on the testicles about LH.
If the hormonotherapy doesn't show any success, then a surgical medical treatment should be carried out. The testicle is operatively impactedly and there fixed into the scrotum. The treatment of the undescended testis should if possible be completed until perfect second year of life. Annual after-controls are required both after a successful hormonal therapy and after a surgical medical treatment up to the puberty.
These informations may be considered a substitute for a piece of medical advice in no case. The content of health-illness.com doesn't can and may be put into any case to make diagnoses or carry out self medical treatment independently.
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