Indications for orchiectomy of undescended testes.
Orchiectomy is indicated when the testis demonstrates in-situ or florid
malignancy and for testes which have been proved to have no useful
psychological, spermatogenic or hormonal function (2). It is also
indicated for testes that are atrophic and cannot be brought down
(5).
Testicular Prosthesis: is
indicated in patients with confirmed absent testes. Usually, the decision
to implant is made only after the young patient experience ridicule
and embarrassment about his genital appearance. Testicular prosthesis
have been shown to eliminate psychosexual adverse effects and patients
more self-confidence (5).
Conclusion. Cryptorchidism is a relatively
common disease which can be easily corrected by surgery, however,
intervention should not be delayed beyond 2 years of age or else
complications, most important of which is infertility, will develop.
It is important to distinguishing between truly undescended and
retractile testes because they mimic each other, but their prognosis
and management are completely different.
REFERENCES:
1-
Hutson J M. "Undescended Testis, Torsion and Varicocele."
Pediatric Surgery, O'Neil, Rowe et.al., 5th edition, 1998, Vol.
2.
2-
Bianchi A. "Microvascular Transfer of the Testes." Pediatric
Surgery, Spitz and Coran, 5th edition, 1992.
3-
Fonkalsrud E W. "Undescended Testes." Pediatric Surgery.
Wrich, Welch, et.al. Chapter 79. p793-796.
4-
Tanyel, F Cahit. "A Reevaluation of the Mechanism of Testicular
Descent: Reasons for Failed Descent or Ascent." Journal of
Pediatric Surgery, 35: 1147-1149, 2000
5-
Nixon H et.al. " Undescended Testis." The Essentials of
Pediatric Surgery, 4th edition, 1993. Chapter 31, p211-220.
|
6-
Raifer J. "Cryptorchidism." The Urologic Clinics of North
America. Oct., 1982
7-
Jockenhovel F, Swerdloff R S: Alterations in the Steroidogenic Capacity
of Leydig Cells in Cryptorchid Testis. In Hutson JM, Beasly SW,
editors: The Cryptorchid Testis, Boca Raton, Fl, 1989, CRC Press.
8-
Smith J A et.al. "The Relationship Between Cerebral Palsy and
Cryptorchidism." The Journal of Pediatrics, 23:275-279, 1989.
9-
Huff D S et.al. "Evidence in Favour of The Mechanical (Intrauterine
Torsion) Theory over The Endocrinopathy (Cryptorchidism) Theory
in the Pathogenesis of Testicular Agenesis." The Journal of
Urology 146: 630-631, 1991.
10-
Docimo, S G et.al. "The Undescended Testicle: Diagnosis and
Management." American Family Physician. 62: 2037-2043, 2000.
11-
Williams E V et.al. "Management ot the Impalpable Testis: A
Six Year Review Together with a National Experience." Postgraduate
Med J. 77: 320-322, 2001.
12-
Barone J G et.al. "DNA Organization in Patients with History
of Cryptorchidism." Urology 56(6): 1068-1070, 2000.
13-
Internet using two search engines. www.google.com. and www.emedicine.com.
14-
Taeuch, H W. Avery's Disease of the Newborn, 7th edition" p206-207,
p222-223, p937.
15-
Hutson J M. "Orchidopexy." Pediatric Surgery, Spitz and
Coran, 5th edition, 1992.
16-
Hurwitz R S et.al. "How Well Does Contralateral Testis Hypertrophy
Predict the Absence of the Non-palpable Testis?" The Journal
of Urology. 165: 588-592, 2001.
17-
Elder, J et.al. "Infant Testicular Prosthesis." The Journal
of Urology. 141: 1413-1415, 1989.
18-
Hutcheston J et.al. " The Anatomical Approach to Inguinal Orchiopexy."
The Journal of Urology. 164: 1702-1704, 2000.
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