Testes
·
= Cryptorchidism
· Descent complete in 96% at birth, in 99% at 3 months
·
Premature will have rate of
undescended testis (5% at 1 year)
·
Two types:
o Arrest of descent: at internal or external ring, or at scrotal neck
o Ectopic: outside of the line of descent
·
May present with a hernia
·
Surgical correction at about 12
months
·
Sequalae of non-descent:
o 20 times risk of malignancy
o ?Impact on fertility (due to ?higher temperature impairs spermatogenesis)
o If don‟t bring them down they may end up over the pubic ramus ® very
uncomfortable sex!
·
If bilateral undescended testis
and hypospadias ® ambiguous genitalia ® urgent referral
· Torsion in utero ® no testis
·
No testis = anorchia. Maybe no kidney on that side Þ check
Retractile Testis
·
Normally in scrotum but retracts
upwards during examination
·
Testis normal size
·
Follow-up 2 yearly
·
Surgery unnecessary. Will drop into scrotum at puberty
·
Fluid collection between the
layers of the tunica vaginalis secondary to trauma, infection or idiopathic.
Implies a patent process vaginalis
·
May be bigger in the evening than
in the morning
· Transluminates well, is non-tender and non-reducible
· Herniotomy if not resolved by age 2. 50% disappear in first year. Remove tunica vaginalis ® removes potential space
·
Predisposes to hernia
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