Cryptorchidism physical examination: Difference between revisions

Jump to navigation Jump to search
m (Bot: Removing from Primary care)
 
(7 intermediate revisions by 3 users not shown)
Line 5: Line 5:
{{CMG}} {{AE}} {{SME}}
{{CMG}} {{AE}} {{SME}}
==Overview==
==Overview==
The most common diagnostic dilemma in otherwise normal boys is distinguishing a retractile testis from a [[testis]] that will not/cannot descend spontaneously into the [[scrotum]]. Retractile testes are more common than truly undescended testes and do not need to be operated on. In normal males, as the [[cremaster muscle]] relaxes or contracts, the testis moves lower or higher ("retracts") in the scrotum. This [[cremasteric reflex]] is much more active in infant boys than older men. A retractile testis high in the scrotum can be difficult to distinguish from a position in the lower inguinal canal. Though there are various maneuvers used to do so, such as using a crosslegged position, soaping the examiner's fingers, or examining in a warm bath, the benefit of surgery in these cases can be a matter of clinical judgement.
The most common diagnostic dilemma in otherwise normal boys is distinguishing a retractile testis from a [[testis]] that will not/cannot descend spontaneously into the [[scrotum]]. Retractile testes are more common than truly undescended testes and do not need to be operated on. In normal males, as the [[cremaster muscle]] relaxes or contracts, the testis moves lower or higher ("retracts") in the scrotum. This [[cremasteric reflex]] is much more active in infant boys than older men. A retractile testis high in the scrotum can be difficult to distinguish from a position in the lower inguinal canal. Though there are various maneuvers used to do so, such as using a crosslegged position, soaping the examiner's fingers, or examining in a warm bath, the benefit of surgery in these cases can be a matter of clinical judgement.
 
In the minority of cases with bilaterally [[non-palpable]] testes, further testing to locate the testes, assess their function, and exclude additional problems is often useful. Pelvic [[ultrasound]] or [[magnetic resonance imaging]] can often, but not invariably, locate the testes while confirming absence of a uterus. A [[karyotype]] can confirm or exclude forms of [[dysgenetic]] primary [[hypogonadism]], such as [[Klinefelter syndrome]] or [[mixed gonadal dysgenesis]].
[[Hormone]] levels (especially [[gonadotropins]] and AMH) can help confirm that there are hormonally functional testes worth attempting to rescue, as can stimulation with a few injections of [[human chorionic gonadotropin]] to elicit a rise of the [[testosterone]] level. Occasionally these tests reveal an unsuspected and more complicated [[intersex]]condition.
 
In the even smaller minority of cryptorchid [[infants]] who have other obvious birth defects of the [[genitalia]], further testing is crucial and has a high likelihood of detecting an[[intersex]] condition or other anatomic anomalies. Ambiguity can indicate either impaired androgen synthesis or [[androgen insensitivity syndrome|reduced sensitivity]]. The presence of a [[uterus]] by pelvic [[ultrasound]] suggests either [[persistent müllerian duct syndrome]] (AMH deficiency or insensitivity) or a severely virilized genetic female with [[congenital adrenal hyperplasia]]. An unambiguous [[micropenis]], especially accompanied by [[hypoglycemia]] or [[jaundice]], suggests congenital[[hypopituitarism]].


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Mature chapter]]
{{WikiDoc Help Menu}}
[[Category:Disease]]
{{WikiDoc Sources}}
[[Category:Psychiatry]]
 
[[Category:Andrology]]
[[Category:Diseases]]
[[Category:Pediatrics]]
[[Category:Pediatrics]]
[[Category:Gastroenterology]]
[[Category:primary care]]
[[Category:Geriatrics]]
[[Category:Needs content]]
[[Category:Needs content]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Latest revision as of 21:11, 29 July 2020

Cryptorchidism Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cryptorchidism from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Abdominal Ultrasound

Other Imaging Findings

Treatment

Medical Therapy

Surgery

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Cryptorchidism physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Cryptorchidism physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA onCryptorchidism physical examination

CDC on Cryptorchidism physical examination

Cryptorchidism physical examination in the news

Blogs on Cryptorchidism physical examination

Directions to Hospitals Treating Cryptorchidism

Risk calculators and risk factors for Cryptorchidism physical examination

Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saumya Easaw, M.B.B.S.[2]

Overview

The most common diagnostic dilemma in otherwise normal boys is distinguishing a retractile testis from a testis that will not/cannot descend spontaneously into the scrotum. Retractile testes are more common than truly undescended testes and do not need to be operated on. In normal males, as the cremaster muscle relaxes or contracts, the testis moves lower or higher ("retracts") in the scrotum. This cremasteric reflex is much more active in infant boys than older men. A retractile testis high in the scrotum can be difficult to distinguish from a position in the lower inguinal canal. Though there are various maneuvers used to do so, such as using a crosslegged position, soaping the examiner's fingers, or examining in a warm bath, the benefit of surgery in these cases can be a matter of clinical judgement.

References

Template:WikiDoc Sources