Cryptorchidism

master's thesis

• Author: Anne-Lise Marie Julie Maixant
• Mentor: Davor Ježek (mentor)
• Committee member: Srećko Gajović (predsjednik povjerenstva)
• Committee member: Dinko Mitrečić (član povjerenstva)
• Committee member: Davor Ježek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Urology); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Urology

Abstract

Cryptorchidism is the most common congenital urogenital anomaly seen in male children. The incidence of cryptorchidism varies from 2-4 % in the male infant population and is more common in premature infants. Mechanisms involved in the etiology of this pathology require an understanding of the underlying embryology of testicular descent. The process of testicular decent has been clearly established to occur in two phases: the intra-abdominal phase and the inguino-scrotal phase. Both are regulated by complex hormonal and genetic factors, among which a balance between androgens and estrogens seems to play an important role. Environmental factors like estrogen disrupters have been incriminated in etiology of cryptorchidism, but their precise role has not yet been clearly established.
Most cryptorchid testis diagnosed at birth will eventually achieve descent by the first three months after birth. Diagnosis of cryptorchidism relies on patient genital examination. A functional classification of palpable or impalpable testis provides the first step in the diagnostic and therapeutic algorithm. While radiological investigation such as ultrasound and computed tomography are of no use in the diagnosis of impalpable testis, laparoscopic exploration provides the most accurate diagnostic method in assessment and localization of impalpable testis. Laparoscopy is ultimately also used in the treatment of cryptorchidism. The current standard therapeutic option relies on surgical repositioning of the gonad within the scrotum. Hormonal treatment is of little value but can be used as an adjuvant therapy to improve fertility rather than stimulating testicular descent. Orchidopexy should be performed by 18 months of age in order to preserve testicular function and decrease risk for malignancy.

• Keywords: undescended testis; gubernaculum; infertility; testicular cancer
• Language: english
• URN:NBN: urn:nbn:hr:105:000125
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-11-20 09:44:44