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Y4R4 - Surgery II 👨‍⚕️ > L3: Undecended Testis > Flashcards

L3: Undecended Testis Flashcards

1
Q

Testis Embryology

A
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2
Q

Testis Embryology

  • Develops at ….
A

develops inside the abdomen at primitive urogenital ridge.

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3
Q

Testis Embryology

  • Descent
A
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4
Q

Testis Embryology

  • Descent is controlled by
A
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5
Q

Testis Embryology

  • Processus Vaginalis
A
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6
Q

Testis Embryology

  • failure of obliteration of processus vaginalis leads to …..
A
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7
Q

Testis Embryology

  • Site of testis
A
  • Testis lies outside the body (in the scrotum) as spermatogenesis is efficient at 2-3° lower than core body temperature 34°
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8
Q

Def of Cryptochidism / Undescended Testis

A

Cryptorchid testes are testes not located normally in the scrotum.

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9
Q

Epidemeology of Cryptochidism / Undescended Testis

A
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10
Q

Etiology of Cryptochidism / Undescended Testis

A
  • Undescended testis is caused by any anomaly of hormonal control or anatomical processes required for normal testicular aescent.
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11
Q

Classification of Cryptochidism / Undescended Testis

A
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12
Q

Classification of Cryptochidism / Undescended Testis

  • Arrest in normal descent
A
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13
Q

Classification of Cryptochidism / Undescended Testis

  • arrest outside the normal line of descent
A
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14
Q

Def of Retractile Testis

A
  • Retractile testes are testes which retract out of scrotum on stimulation of sensory branch of genitofemoral nerve (stimulation of cremastric reflex)
  • but then return to scrotum within 10-20 seconds.
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15
Q

TTT of Retractile Testis

A

Diagnosis of Retractile Testis → No surgical treatment is required.

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16
Q

Def of Ascending Testis

A
  • Ascending testis is a testis that was in scrotum at birth/ 3 months of age but then reascends with progressive increase in size of boy.
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17
Q

Causes of Ascending Testis

A
  • It is caused by a persistence of an obliterated fibrous remnant of processus vaginalis) that hinders the normal process of growth & elongation of the spermatic cord with age.
  • Testicular ascent may also be acquired by fibrosis resulting from previous groin operation (e.g: Inguinal hernia repair).
18
Q

Complications of Cryptochidism

A
19
Q

Complications of Cryptochidism

  • Infertility
A
  • Unilateral UDT → Fertility is eauivalent to that of the normal population (~90%).
  • Bilateral UDT → paternity rates of 50-65% even if corrected early
20
Q

Complications of Cryptochidism

  • Malignancy
A
  • Risk in abdominal testes > Inguinal testes
21
Q

Complications of Cryptochidism

  • Inguinal Hernia
A

(patent processus vaginalis)

22
Q

Complications of Cryptochidism

  • testicular Torsion
A
  • As the testis is not fixed to the scrotum and more mobile (especially when at superficial inguinal pouch)
23
Q

Complications of Cryptochidism

  • Trauma
A

The testis is more liable to trauma at inguinal or abdominal position.

24
Q

Complications of Cryptochidism

  • Psychological Effect
A

…

25
Q

Dx of Cryptochidism

A
26
Q

Dx of Cryptochidism

  • Clinical Dx
A
27
Q

Dx of Cryptochidism

  • INVx
A
28
Q

Dx of Cryptochidism

  • Labs
A
29
Q

Dx of Cryptochidism

  • Rad
A
30
Q

Dx of Cryptochidism

  • Laparoscopy
A

current gold standard

31
Q

Management of Cryptochidism

A
  • Hormonal TTT
  • Surgical TTT
32
Q

Management of Cryptochidism

  • Hormonal TTT
A
33
Q

Management of Cryptochidism

  • SE of Hormonal TTT
A
34
Q

Management of Cryptochidism

  • Is Hormonal TTT First Line?
A

Many surgeons do not consider the success rates high enough to be worth the trouble since surgery itself is usually simple and uncomplicated.

35
Q

Management of Cryptochidism

  • Surgical
A
36
Q

Surgical TTT of Cryptochidism

A
37
Q

Surgical TTT of Cryptochidism

  • Timing
A
38
Q

Surgical TTT of Cryptochidism

  • Benifits
A
39
Q

Surgical TTT of Cryptochidism

  • Principles
A
40
Q

Surgical TTT of Cryptochidism

  • Approaches
A

Y4R4 - Surgery II 👨‍⚕️ (33 decks)

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