chryptorchidism

Dear doctor Mantilla:
To improve spermatogenesis (producing an adequate number of spermatozoids)
undescended testis should be managed before the age of two. Electron
microscopy has confirmed an arrest in spermatogenesis (reduced number of
spermatogonias and tubular diameter) in undescended testis after the first
two years of life.
Other reasons to pex are: a higher incidence of malignancy, trauma and
torsion, and future cosmetic and psychological problems in the child.
The management is surgical; hormonal (Human Chorionic Gonadotropin)
treatment has brought conflicting results except in bilateral cases.
Surgery is limited by the length of the testicular artery. Palpable testes
have a better prognosis than non-palpable. It is difficult to determine
either location or absence of the non-palpable undescended testis (NUT) by
clinical examination. Imaging studies (US, CT, MRI, gonadal venography,
etc.) are not reliable in proving its absence. Diagnostic laparoscopy is
reliable in locating the NUT or proving its absence. Furthermore it can be
combine to provide surgical management.
In your case would opt to start by doing a diagnostic laparoscopy through
the navel and determining whether the testicular vessels ends blindly or not.
--tito lugo

>>> The URL's of "PEDIATRIC SURGERY Update" are:
http://home.coqui.net/titolugo
http://www.upr.clu.edu/psu <<<

********************************************
HUMBERTO L. LUGO-VICENTE, MD, FACS, FAAP
Associate Professor Pediatric Surgery
University of Puerto Rico, School of Medicine and the
University Pediatric Hospital, Rio Piedras, Puerto Rico
Chief- Section of Pediatric Surgery
San Pablo Medical Center, Bayamon, Puerto Rico
E-mail: hidden@email-address
URL: http://home.coqui.net/titolugo/informat.htm
********************************************
********************************************