Genito-Urinary tract Congenital anomalies

Terms in this set (33)

CP:
a) temperature inside the scrotum is lower than the body T by about 1 degree celcius this is essential for maturation & fuction of the semineferous tubule of the testis, undescended testis starts to show microscopic changes by age of two years, by age of 4 years there is massive collagen deposition in semineferous tubule, the later become incapable of spermatogenesis (infertile)
b) the undescended testis & ectopic testis are more liable to trauma & torsion.
c) cryptorchoid testis has greater liability to malignancy than N testis
d) a cong inguinal hernia is often ass w testicular maldescent.

XM:
- w cryptorchidism the scrotum on affected side is empty & atrophic
- undescended testis mb palpable (at the ext inguinal ring or neck of scrotum or intra abdominal)
- ectopic testis is eaaily palpable, M/C in the supf inguinal pouch.

IX:
- if testis is not palpable, US and /or CT are indicated to identify the cryptorchoid testis.

TX: the testis should be brought down to scrotum b4 age of 2 years
a) HORMONAL THERAPY
- it is successfull in only a few cases
- we use chorionic gonodotropin 500 IU weekly for 3 mo OR 3times per week for 3 weeks
- if succesful the testis wil go down within one mo
- the course should not be repeated.

b) surgical rx:
- orchiopexy + repair of ass inguinal hernia
- the testicle is mobilised diwn to the scrotum & fixed there; the vas & bl vessel must be carefully preserved
- unilateral undescended testis presenting after puberty mb brought down to the scrotum or removed for fear of malignancy.
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