Anorchidism

Introduction to testosterone There is no testicular disease, also known as congenital testicular absent, the child is born unilateral or bilateral simple testicular, the external genitalia is male, the sex chromosome is not abnormal, clinically rare, divided into unilateral and bilateral testes There are two types missing. Testicular syndrome should be distinguished from partial or complete testicular atrophy caused by spermatic cord torsion or orchitis. In these cases, at least histologically, the testis tissue can be found to be degraded. Testicular disease can be congenital or It is acquired. basic knowledge Probability ratio: extremely rare, 0.0001% Susceptible people: male Mode of infection: non-infectious Complications: male infertility azoospermia impotence

Cause of no testis

Testicular atrophy (35%):

The cause of congenital testicular deficiencies has not been confirmed so far and may be related to the following factors. Pregnancy or before birth, shortly after testicular torsion, spermatic cord embolization, testicular blood flow supply blocked and testicular atrophy, may be the most common cause.

Dysplasia (35%):

At 8 weeks of gestation, testicular tissue begins to develop and secrete anti-Müllerian hormone (AMH), which then secretes testosterone. If testicular tissue is lost before secretion of testosterone, Müller tube has degenerated, but androgen-dependent Wolff tube differentiation and The genitourinary sinus and the male genital genitalization have not yet begun. If the testicular tissue originally exists and secretes testosterone for a period of time, the androgen-dependent genitourinary target organs will develop to the direction of the male. Congenital bilateral non-testosterone patients can not only detect testicular tissue from histologically, but also can not find testicular function from endocrine function. In children, serum follicle-stimulating hormone (FSH) and plasma luteinizing hormone (Luteotropic hormone, LH) has risen to the level of castration at the time of puberty, while testosterone levels are low.

Testicular prevention

The disease belongs to sex chromosome disease, and the cause of chromosomal abnormality is unclear. It may have certain correlation with environmental factors, genetic factors, dietary factors, and mood and nutrition during pregnancy. Therefore, this disease cannot be directly prevented. Regular examination should be done during pregnancy. If the child has a tendency to develop abnormalities, chromosome screening should be done in time, and abortion should be performed in time to avoid the birth of the diseased child.

No testicular complications Complications male infertility azoospermia

This disease is easy to cause infertility. There is no sexual desire and azoospermia, impotence, etc. and lead to infertility. At the same time, the main function of the testis is to secrete androgen, so patients without testicular can reduce the secretion of androgen due to the loss of testicular, secondary sexual characteristics and genital development are limited, due to the reduction of androgen, causing estrogen relative hyperactivity Feminization of the feminization of the sound and breast development may occur.

No testicular symptoms common symptoms no testicular gonadal dysplasia blood testosterone reduction

The unilateral testicular absent, the penis, scrotum development is normal, due to compensatory hyperplasia of the healthy testis, normal testosterone levels in the blood, normal second sexual characteristics in puberty, lack of bilateral testicular, patients with no developmental ability, eunuch Type development, manifested as subcutaneous fat plump, delicate skin, high tone, physical examination found scrotal dysplasia, scrotum empty testicles, penis small, no pubic hair growth.

Test without testosterone

The sex hormone test has certain guiding significance in judging the presence or absence of testis and determining whether or not to perform surgical exploration. The bilateral testes cannot be touched. If LH, FSH is elevated, intramuscular injection of chorionic gonadotropin (HCG) 1000- 1500U, once every other day, after a total of 3 times, the serum testosterone is not elevated, can be diagnosed as congenital testicular absence, no need for surgical exploration, if the injection of HCG, serum testosterone levels or serum testosterone no change, However, LH, FSH does not increase, because at least one testicle exists, it must be surgically explored.

Invasive examinations such as testicular artery or venography have low accuracy and certain complications, and are rarely used. Non-invasive tests, such as B-ultrasound, CT, MRI, etc., are not specific and can only be used as a reference. At present, the application of laparoscopic techniques can safely and accurately diagnose the cryptorchidism and testicular defects in the abdomen, thus avoiding blind exploration.

Diagnosis of no testis

Diagnostic criteria

Testicular dysplasia is often diagnosed in cryptorchidism surgery, which is about 3.3% of cryptorchidism surgery. About 20% of patients who cannot touch the testis before surgery can not find testicles.

Diagnosis of congenital testicular dysplasia is difficult. The presence of cryptorchidism or ectopic testis must first be ruled out, especially with the bilateral cryptorchidism that cannot be touched.

Unilateral testicular deficiencies, such as the application of sex hormone test, have no screening effect, and should be promptly performed for surgical exploration. The purpose is to find out whether there are testicles in the body, and to find out the exact position of the testicles in the body, and to testicular fixation or resection.

Differential diagnosis

1. The cryptorchidism is easy to be confused with no testicular syndrome, but the cryptorchidism still has male developmental characteristics, such as muscle development, larynx development, low sound and loud, pubic hair is male distribution, and the testicle can be touched in the groin during physical examination. Or B-ultrasound, CT test and surgical exploration revealed testicular,

2. Male pseudohermaphroditism often combined with bilateral cryptorchidism, but there are severe deformities of the external genitalia, such as hypospadias, scrotal division, like female vulva, B-ultrasound or surgical exploration can be found in the testis,

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