Thursday, March 2, 2023

A case of ectopic or undescended testis

This patient had absent right testis in the scrotum. 
Ultrasound images show the right testis in the inguinal region.

Undescended testis (UDT) refers to a condition in which one or both testes fail to descend into the scrotum during fetal development. UDT is more common in boys and can result in complications such as infertility, testicular torsion, and malignancy. Sonography is a valuable non-invasive tool for diagnosing and evaluating UDT.

When performing sonography of a right inguinal testis in the pediatric age group, the following findings may be observed:

  1. Absence of the right testis in the scrotum: The testis may be absent from the scrotum and may be located anywhere along the pathway of descent. The absence of the testis in the scrotum is a key finding in the diagnosis of UDT.

  2. Presence of a mass or a cystic lesion: A palpable mass or cystic lesion may be observed in the inguinal region, which may represent the undescended testis.

  3. Abnormal testicular morphology: The undescended testis may appear small, hypoplastic, or atrophied due to inadequate blood supply and exposure to higher intra-abdominal temperatures.

  4. Absence or altered blood flow: Doppler ultrasound may demonstrate decreased or absent blood flow to the undescended testis, indicating a potential risk for torsion or malignancy.

  5. Associated anomalies: In some cases, UDT may be associated with other congenital anomalies such as inguinal hernia, hypospadias, or renal anomalies.

  6. Potential complications: Sonography is also useful for detecting potential complications such as testicular torsion or malignancy, which may require urgent intervention.

In summary, sonography of a right inguinal testis in the pediatric age group can provide valuable information for the diagnosis and management of UDT. Early detection and management of UDT are crucial for preserving testicular function and preventing complications.

What is the management of undescended testis?

An undescended testis occurs when a testicle fails to descend into the scrotum, usually by the time a male infant is 6 months old.

Treatment should be initiated before the age of 1, as delayed management can lead to infertility, testicular cancer, and other complications.

Treatment options include hormone therapy or surgical intervention.

Hormone therapy involves the use of gonadotropin-releasing hormone, which stimulates the production of testosterone, and can help the testicle descend into the scrotum.

Surgery is the most effective treatment option and involves a procedure called orchiopexy, which involves moving the testicle into the scrotum and securing it in place.

The success rate of treatment is high, with most cases resulting in the successful descent of the testicle.

Regular follow-up visits with a urologist are necessary to monitor for complications and ensure proper development of the testicle

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Sonography of ectopic testis


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