Exam 2 - Cryptorchidism Flashcards
Define cryptorchid.
It is a medical term that refers to failure of one or both testicles to descend into the scrotum
Crypt means what?
hidden
Orchid means what?
testes
If a patient is unilaterally cryptorchid are they sterile or fertile? Bilateral?
Unilateral = fertile Bilateral = sterile
If a patient is inguinally cryptorchid where is the testicle located?
outside of the abdomen
If a patient is abdominally cryptorchid where is the testicle located?
inside of the abdomen
What type of congenital defect is canine cryptorchidism?
sex-linked autosomal recessive trait
What is the incidence of canine cryptorchidism?
1.2-10%
What is the most common presentation/form of canine cryptorchidism?
right unilateral cryptorchidism makes up 75% of the cases
Are large or small breeds more predisposed to canine cryptorchidism?
small breeds are 2.7 times more likely
True or False: It is wise to breed a unilateral cryptorchid.
False - that would be dumb considering it is hereditary
At what age should canine testicles be descended by?
2 months of age
What are some clinical signs of crypthorchidism?
male marking behavior and aggression
What complications are associated with canine cryptorchidism?
There are 13.6 times more likely to develop neoplasia in the retained testicle and have a risk of testicular torsion
How does testicular development typically occur?
The testicle is descended by day 10, and can move in and out of the scrotum
Intra-abdominal migration occurs via the gubernaculum pulling it into the inguinal canal
Inguinal-scrotal phase occurs that pushes the testicles into the scrotum
What is the incidence of feline cryptorchidism?
0.37-3.8%
right or left
What breeds have an increased risk of having feline cryptorchidism?
Persian and Himalayan cats
When should testicles be descended by in cats?
2 months of age
What clinical signs are associated with feline cryptorchidism?
Male marking behavior, male odors, and aggression
What complications are associated with feline cryptorchidism?
Fewer incidences of testicular neoplasia than dogs but it is still a risk
Testicular torsion
What is another name for equine cryptorchidism?
Rig or ridgling, or high flanker if it is in the inguinal canal
What is the incidence of equine cryptorchidism?
17%
What is the most common ‘presentation’ of equine cryptorchidism?
Unilateral with the left testicle
What breeds have the increased risk of equine cryptorchidism?
Quarter horse, Saddlebred, Percheron, and ponies
True or False: Equine cryptorchidism is heritable
True - so if it is present then there should be a bilateral castration
When should testicles be descended in the horse?
at birth
What signs and complications are associated with equine cryptorchidism?
stallion behavior - no known association with testicular neoplasia
How is cryptorchidism diagnosed?
PE, laboratory evaluation, and diagnostic imaging
What areas should be evaluated during PE of a suspect cryptorchidism?
scrotum, pre-scrotal region, and inguinal canals
How may a cryptorchid testicle feel on palpation?
it may be smaller and softer
What is monorchidism?
absence of one testicle - rare in the horse, not reported in the dog
What results may you find on laboratory tests in a cryptorchid patient?
Testosterone levels will be increased after HCG administration
How is cryptorchidism treated?
Via removal of both testicles - DO NOT TRY TO PULL THE TESTICLE INTO THE SCROTUM
Which testicle should be removed first when castrating a cryptorchid patient?
Remove the undescended testicle first - if you cannot find it then refer the patient
What are the surgical approaches for cryptorchidism?
Laparoscopic removal or traditional surgical approach
If there is an extra-inguinal testis, what surgical approach is recommended?
Standard pre-scrotal midline location - remove it like a regular castration
How should you do a castration in a cryptorchid where the testis is located in/near the inguinal canal?
Make the incision directly over the inguinal ring
Dissect carefully and look for testis
Be careful of fat and large vessels in this region
Use traction on extension of the gubernaculum if it is in the ring
If there is bilateral intra-abdominal cryptorchidism, where are the commonly located and what approach should be done?
They are commonly located caudal to the kidneys
Ventral midline approach should be done
If there is unilateral intra-abdominal cryptorchidism where is the testis commonly located?
by the bladder
What are the two techniques finding a unilateral intra-abdominal cryptorchid for surgery?
Identify the ductus deferens at the prostate and follow it to the retained testicle
Identify the gubernaculum from the inguinal ring and follow it to the retained testicle
What are the pros to the ventral midline approach for castrating a cryptorchid?
It is on the linea alba and easier to close
What are the cons to the ventral midline approach for castrating a cryptorchid?
May be far away from the testicle
What are the pros to the paramedian approach for castrating a cryptorchid?
Avoids dissection around the prepuce and is closer to the bladder
What are the cons to the paramedian approach for castrating a cryptorchid?
You are going through muscle
Describe the paramedian approach for castrating a cryptorchid.
Use a scalpel to incise the skin and subcutaneous tissue
Sharply incise the rectus abdominus muscle fascia
Grid muscle bluntly with fingers
Tent the peritoneum and incise
Follow the vas deferens or gubernaculum to locate the testicle
Closure routine
What are the pros to the para-inguinal approach for castrating a cryptorchid?
close to bladder and internal inguinal ring
What are the cons to the para-inguinal approach for castrating a cryptorchid.
going through muscle
Describe the para-inguinal approach for castrating a cryptorchid.
same surgical process as paramedian
What are the pros to the laparoscopic approach for castrating a cryptorchid?
smaller incision; visualization
What are the cons to the laparoscopic approach for castrating a cryptorchid?
Advanced training; increased surgical time
How should a patient be placed on the table when performing a laparoscopic castration?
place the patient head down
List all of the methods of castration in a cryptorchid.
Ventral midline, standard approach (ligation), paramedian, para-inguinal, and laparoscopic
What post-operative care is recommended after a cryptorchid surgery?
Rest and incision care
The length of time depends on the approach and it can take weeks to months for behaviors to resolve
