Subdirector de la Carrera de Especialista en Endocrinología Pediátrica, Universidad de Buenos Aires. La criptorquidia es la anomalía genital más común en el recién nacido varón .. alternativas: la cirugía a cielo abierto o la laparoscopia. Acta Pediátrica de México Volumen 27, Núm. 6, noviembre-diciembre, Criptorquidia. Nueva Se analiza qué pacientes requieren cirugía y cuáles Palabras clave: Criptorquidia, testículos, tratamiento hormonal, tratamiento quirúrgico. Revista Mexicana de Cirugía Pediátrica 15 years of age, with criptorquidia inguinal, patients by means of orquidopexia paraescrotal, in a pediatric Hospital.
|Published (Last):||13 September 2016|
|PDF File Size:||8.83 Mb|
|ePub File Size:||10.67 Mb|
|Price:||Free* [*Free Regsitration Required]|
Effects of hormonal treatment on the contralateral descended testis in unilateral cryptorchidism J. Patients under hCG treatment can present reversible symptoms, such as local pain, peditarica growth, erections, pubic hair growth and changes in behavior. Therefore, it is important in the presence of unilateral cryptorchidism associated with other anomalies of external genitalia, bilateral cryptorchidism or absence of palpable testis, to rule out a DSD by karyotype analysis, hormonal determinations and image studies.
This study proposes that cryptorchidism is secondary to a primary testicular defect. Nine GnRH studies were randomized and could be included in the study, while since only 2 hCG studies were randomized, they were excluded from the meta-analysis.
Existen factores de riesgo asociados como antecedentes familiares, RCIU, bajo peso al nacer, tabaquismo durante el embarazo, diabetes gestacional. Even though no treatment is necessary 4these patients need to be followed to confirm the scrotal location Surgical success is evaluated by the percentage of testes remaining in the scrotal sac, not atrophic, one year after surgery during follow up. The boy can be in the recumbent position.
Very few studies had reported on the quality of sperm as a function of age at orchidopexy. In a recent work, Ferlin A y col 23 analyzed the frequency of genetic abnormalities in patients with a history of isolated criptorchidism.
The role of this early activation of the hypothalamo-piyuitary-gonadal H-P-G axis is not clear yet, but it is postulated that it would favor the future development of fertility, among other possible functions. Risk of contralateral testicular cancer among men with unilaterally undescended testis: In advanced puberty and in adulthood there is a negative correlation between inhibin B and FSH serum levels. Thus, sex cords are formed around the th week, the first sign of differentiation of the bipotential gonad.
Fertility alter bilateral criptorchidism.
criptorquidia cirugia pediatrica pdf
The technique is effective, safe, with low risk of complications, reproducible and with better aesthetic results, allowing correction simultaneous of associated inguinal pathologist. It might be also useful to detect abnormal internal genitalia or tumors.
This is the transitory post natal elevation of gonadotropins with consequent stimulation of Leydig cells and increases in serum testosterone. Indeed, the risk for testicular- cancer was almost 6 times higher in subjects who had had no correction of cryptorchidism or late testicular descent To facilitate palpation the use of soaped hands is useful.
The results allow to corroborate that dissection pedoatrica the elements vascular is made without difficulty by goes paraescrotal, avoiding dissection of the inguinal channel.
Testículo no descendido – Síntomas y causas – Mayo Clinic
Ann Surg Criptorquisia a study of a Dutch population, the prevalence of cryptorchidism was 1. Presently, the optimal treatment for cryptorchidism is an important subject in international meetings. Indian J Pediatr The molecular basis of cryptorchidism.
Immediate surgical complications, such as hematomas and infections are rare. On the other hand, another ligament the cranial suspensory ligament CSL sustains the gonad to the posterior abdominal wall. However, the available evidence on the potential beneficial effects of coadjutant therapy with GnRH needs confirmation. The higher prevalence in certain populations and geographical areas suggest the presence of genetic and environmental factors. May be these patients have prior testicular damage, independently of age at surgery 54, 60, It is retrospective, observacional, descriptive and cross-sectional a study, in a group of patients between 1 and 15 years of age, with criptorquidia inguinal, patients by means of orquidopexia paraescrotal, in a pediatric Hospital.
However, even though there is an association between cryptorchidism and testicular cancer, only a small proportion of the population develops these two entities in life.
Age at unilateral orchiopexy: Randomized and non-randomized studies were included to increase statistical weight, totaling children and non descended testes.
criptorquidia cirugia pediatrica pdf – PDF Files
The gubernaculum is enlarged by increasing its water contents widening criptorqiudia inguinal canal reaching a maximum around the 7th months of fetal life. The testis remains anchored to the internal inguinal orifice by the gubernaculum arising from the growth of other embryonic structures.
Even though side effects have been reported with surgical treatment injury to vas deferent and testicular vasesthe rate of complications and relapse are not higher when surgery is carried out before 2 years of age 59, 60, Two mechanisms have been postulated: All these alterations would be secondary to early abnormalities in the differentiation of Sertoli, Leydig cieugia germ cells during embryonic life.
Lessons from the eighteenth century. Apoptotic cell death in the normal and cryptorchid human testis: Human models pedatrica cryptorchidism in which there is a deficiency in androgen production are: Classically, two phases are cfiptorquidia Eventually, a hCG test to assess possible presence of testicular tissue in the abdomen.
Surgical treatment of unilaterally undescended testes: After testicular localization at the base of the scrotum, there is fibrosis of the gubernaculum and obliteration of the peritoneal connection.
These values suggest Leydig cell damage. Localization, volume and consistency of testes should be registered. The relative risk RR of oediatrica cancer was increased comparing with the normal population.
A metaanalysis including four studies, revealed that the risk of developing a tumor was significantly increased when orchidopexy was carried out after years of age.
This testicular behavior is explained by a contractile hyperactivity of the cremaster muscle cremaster reflex. A role has been proposed for environmental agents interacting with genetic factors which disrupt the process of testicular descent.