046 Etiology, Diagnosis, and Management of Undescended Testis Flashcards
Gonadal determination involves separate genetic pathways for development of testis and ovary and __ is a master switch in males that regulates downstream testis-determining genes.
Gonadal determination involves separate genetic pathways for development of testis and ovary and SRY is a master switch in males that regulates downstream testis-determining genes.
Differentiation of gonocytes, Sertoli and Leydig cells occurs between__ gestation and the gubernaculum, the guide for testicular descent, appears at __.
Differentiation of gonocytes, Sertoli and Leydig cells occurs between 5 AND 9 WEEKS gestation and the gubernaculum, the guide for testicular descent, appears at 7 WEEKS.
Levels of the Leydig cell hormones testosterone and INSL3 peak between __, and are critical for testicular descent.
Levels of the Leydig cell hormones testosterone and INSL3 peak between 14 AND 17 WEEKS, and are critical for testicular descent.
Swelling of the gubernaculum, which starts in the second trimester, provides space for passage of the testis into the scrotum between __.
Swelling of the gubernaculum, which starts in the second trimester, provides space for passage of the testis into the scrotum between 20 AND 28 WEEKS.
Cryptorchidism occurs in __ of full-term males; both spontaneous descent (in the first few months of life, usually by 6 months) and reascent of testes may occur.
Cryptorchidism occurs in 1–4% of full-term males; both spontaneous descent (in the first few months of life, usually by 6 months) and reascent of testes may occur.
The causes of cryptorchidism are largely unknown, but __, __, and __ likely contribute to disease risk.
The causes of cryptorchidism are largely unknown, but BIRTH WEIGHT, GESTATIONAL AGE, and GENETIC AND ENVIRONMENTAL RISK FACTORS likely contribute to disease risk.
__ is not uncommon but is likely equivalent to cases diagnosed at birth. It may occur after scrotal testes are confirmed at birth, or after spontaneous descent of a cryptorchid testis, and may be more common in boys with retractile testes. Yearly testicular exams are recommended during childhood.
ACQUIRED CRYPTORCHIDISM is not uncommon but is likely equivalent to cases diagnosed at birth. It may occur after scrotal testes are confirmed at birth, or after spontaneous descent of a cryptorchid testis, and may be more common in boys with retractile testes. Yearly testicular exams are recommended during childhood.
About __ of undescended testes are palpable and __ are unilateral.
About 80% of undescended testes are palpable and 60–70% are unilateral.
__ and a __ are common in cases of cryptorchidism.
EPIDIDYMAL ANOMALIES and a PATENT PROCESSUS VAGINALIS are common in cases of cryptorchidism.
Subsets of boys with cryptorchidism have subtle abnormalities of the hypothalamic-pituitary-gonadal axis during mini-puberty and/or reduced levels of hormones secreted by __, __, or __.
Subsets of boys with cryptorchidism have subtle abnormalities of the hypothalamic-pituitary-gonadal axis during mini-puberty and/or reduced levels of hormones secreted by SERTOLI CELLS, AMH, or INHIBIN B (INHB).
__ is recommended for testes that remain undescended after 6 months of age; hormone therapy is not recommended.
ORCHIDOPEXY is recommended for testes that remain undescended after 6 months of age; hormone therapy is not recommended.
__ is the procedure of choice and imaging studies are rarely useful in the diagnosis and treatment of nonpalpable abdominal cryptorchidism.
LAPAROSCOPY is the procedure of choice and imaging studies are rarely useful in the diagnosis and treatment of nonpalpable abdominal cryptorchidism.
Immediate urologic consultation is required for all phenotypic male newborns with bilateral, nonpalpable testes for evaluation of a possible __. A newborn with a male phallus and bilateral nonpalpable gonads is potentially a genetic female (46,XX) with congenital adrenal hyperplasia until proven otherwise.
Immediate urologic consultation is required for all phenotypic male newborns with bilateral, nonpalpable testes for evaluation of a possible DSD. A newborn with a male phallus and bilateral nonpalpable gonads is potentially a genetic female (46,XX) with congenital adrenal hyperplasia until proven otherwise.
Sperm counts are __ in at least 25% of formerly unilateral and the majority of formerly bilateral cryptorchid men, but paternity rates in the unilateral group are similar to control men.
Sperm counts are REDUCED in at least 25% of formerly unilateral and the majority of formerly bilateral cryptorchid men, but paternity rates in the unilateral group are similar to control men.
__ may predict fertility potential in some males with cryptorchidism.
AD SPERMATOGONIA COUNTS may predict fertility potential in some males with cryptorchidism.
