Source: Seek a Doctor And Ask Medicine Network Time: 2018-11-16 Publisher: Jing Xiao Bookmark this article
Speaking of the problem of cryptorchidism, many people may not know much, experts say that the occurrence of cryptorchidism is very harmful to men's health, and such diseases may also cause male infertility, so when the disease occurs, it must be timely examination and treatment, the following follows the small editor to understand the examination and treatment methods that should be engaged.
What are the methods of examination of cryptorchidism
1, B type ultrasound examination is currently the most commonly used method, this examination has no damage and can also check whether the patient has hydronephrosis, malformations, stones and other urinary system lesions, for the inguinal canal cryptorchidism has a fairly high diagnostic rate, but the diagnostic rate of intra-abdominal cryptorchidism is not high enough.
2. Selective intracoceleatic angiography is a widely used method that can diagnose the location of cryptorchidism, or the absence of testes, from the morphology of the end of the intracocele vein after contrast injection. However, intracoceles venous imaging is often affected by the venous flap and is difficult to operate in children under 2 years of age.
3. Electronic computed tomography (CTScan) and magnetic resonance imaging (MRI) have also been used in recent years for the localization diagnosis of intra-abdominal cryptorchidism, and they have considerable accuracy. The disadvantage of these two tests is that they are difficult and expensive to examine in younger children.
4. Laparoscopy has been widely used in the diagnosis and treatment of intra-abdominal cryptorchidism in recent years, and the scope of application of laparoscopy can be widely used for cryptorchidic patients of various ages and children under 1 year old, the operation method is simple and short, and the diagnosis rate of cryptorchidism can reach 88% to 100%. The location of the cryptorchidism or the absence of testicles can be determined, and in laparoscopy, the testicular vessels can be found along the anatomical position of the testicular vessels behind the peritoneum along the spermatic cord blood vessels, and the testicles located in the abdomen or the inner ring of the groin can be found, and if the blind end of the blood vessels is seen along the blood vessels, it can be determined that the testicles are absent. If there is a nodule on the blind end, it should be removed and sent for pathological examination.
Treatment of cryptorchidism:
1. Hormone therapy
The cause of cryptorchidism, especially bilateral cryptorchidism, may be endocrine-related, so endocrine therapy can be given after the age of 1 year, and the endocrine currently used is:
(1) Chorionic hormone (HCG): the purpose of treatment is to improve the function of interstitial cells (leydig's cell) and support cells (Sertoli cell), promote testicular development, increase testosterone secretion, promote testicular decline, the effective rate is about 14% to 50%, the dose is 1000 ~ 1500U, intramuscular injection every other day, follow-up after 1 month, the total amount should be > 10,000 U, 20,000 U does not increase the efficacy, on the contrary, there will be adverse reactions that promote testicular atrophy.
(2) Luteinizing hormone-releasing hormone (LH-RH): the effective rate is 30% to 40%, the dose is 1.2mg/day, each nostril is 200μg, 3 times/day, inhaled through nasal nebulizer, 4 weeks is 1 course of treatment, follow-up after 3 months.
(3) LH-RH HCG: the combination of the two can improve the efficacy, the dose of LH-RH 1.2 mg / day, inhaled in three nasal nebulissive doses, after 4 weeks HCG 1000 ~ 1500U, once a week, for a total of 3 weeks.
2. Surgical treatment
Testicular fixation is the main method of treatment of cryptorchidism, the initial diagnosis has been more than 6 months or hormone therapy is ineffective, surgery can be performed after 1 year of age, the use of inguinal oblique incision of the testicular meat membrane sac external fixation has been widely used at home and abroad, the spermatic vessel is too short cryptorchidism can be divided into two stages of surgery, in order to fully ensure the blood supply of the testicles, but there is also the possibility of the second surgery accidental injury of spermatic vessels, for the long vas deferens high cryptorchidism can be applied Towler-Stephens technique, recently recommended this method of improvement of this technique, Fowler-Stephens stage surgery, that is, the initial surgery only cuts the spermatic vessel pedicle at a high level, without testicular fixation, and the second stage is fixed in the scrotum after the enriched collateral circulation is established, reducing the chance of testicular atrophy.
The problem of cryptorchidism, our patients can be timely examination and treatment is the key to effectively cure the disease, the above small series also summarized the examination and treatment of cryptorchidism disease for everyone, hoping to help patients correctly check and treat after suffering from the disease, and make the disease recover as soon as possible.