TESTICULO RETRACTIL PDF

It may refer to an undescended testis, ectopic testis , or an atrophic or absent testis. Correct localization of the testes is essential because surgical management varies on location. The gubernaculum is the ligament which connects the testes to the scrotum. Under hormonal influence probably testosterone , the gubernaculum contracts, and the testes descend into the scrotum.

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Clinical importance and prevalence of testicular microlithiasis in pediatric patients 1. Involved in the design, collect of data and helped to draft the manuscript. METHODS: Between January and January , we evaluated, prospectively children ranging from 1 to 15 years with inguinoscrotal affections with a high-frequency ultrasound system, which employs a MHz transducer. Testicular microlithiasis was found in 5 children with cryptorchidism 3. The children with testicular microlithiasis were submitted to annual physical examinations and ultrasound evaluations.

The association with cryptorchidism, retractile and hypotrophic testis was significant. Testicular microlithiasis TM is rare. However, it has come to be encountered more frequently due to the increased number of situations in which high-resolution ultrasound is used in the inguinoscrotal region to investigate testicular size in cryptorchidism or patency of the peritoneal-vaginal duct.

The typical presentation of TM is diffuse calcification consisting of hydroxyapatite crystals surrounded by layers of collagen fibers in the seminiferous tubules. There is evidence that. TM is a precursor of testicular germ cell tumors 1,2 and that it is associated with infertility 3. However, it remains unknown whether these are true cause-and-effect relationships or just incidental findings. The incidence of TM is from 0.

The aim of the study was to evaluate the prevalence of TM among pediatric patients with inguinoscrotal affections.

Between January and January , we evaluated, prospectively children ranging from 1 to 15 years mean age: 7, 5. The children with cryptorchidism, retractile testis, hypotrophy of the testis, and inguinal hernia were submitted to ultrasound scans of the testis. The follow-up period ranged from 6 months to 5 years. An experienced specialist operated the high-frequency ultrasound system Power Vision , Toshiba , which employs a MHz transducer.

TM was characterized as distributed hyperechogenic microliths measuring less than 3 mm in diameter and seen in a single ultrasound scan.

The distribution of the calcifications was diffuse or focal, uni or bilateral Figure 1. Among the children evaluated, patients 8. A total of 20 testicles in 11 children 0. We observed that 5 children with cryptorchidism 3. Nine children 4 with cryptorchidism, 4 with retractile testis and 1 with inguinal hernia had bilateral disease.

The relative risk of testicular microlithiasis calculated for patients with retractile testicle, cryptorchidism, testicular hypotrophy, and inguinal hernia were respectively These children were submitted to annual follow-up with physical examinations and ultrasound evaluations. The co-occurrence of TM with testicular tumors was not found in this study of pediatric patients. Table 1. High-resolution inguinoscrotal ultrasound is a sensitive diagnostic tool, especially when high-frequency linear transducers are used.

It has come to be more widely used in recent years due to improvements in the quality of ultrasound equipment. Inguinoscrotal ultrasound can identify scrotal calcifications, which can be either intratesticular or extratesticular. Extratesticular scrotal calcifications are more common and are associated with inflammation of the epididymis and tunica albuginea.

Smaller intratesticular scrotal calcifications can be characterized as TM, whereas larger ones are typically secondary to phlebolith, spermatic granulomas, vascular calcification, or tumors.

Those that cast an acoustic shadow are therefore not considered characteristic of TM 5,6 , which is defined as five or more randomly distributed hyperechogenic microliths measuring less than 3 mm in diameter and seen in a single ultrasound scan. The distribution of the calcifications can be diffuse or focal, and the TM can be unilateral or bilateral.

The most common form of presentation is tiny specks of echogenic foci distributed diffusely, bilaterally, and symmetrically within the testicular parenchyma 1,7. This pattern of presentation was found in our study. The disease was diffusely distributed and bilateral in 9 of 11 children. Although there is no known cause of TM, it is thought to result from a degenerative process in the seminiferous tubule epithelium.

This process produces cellular debris that migrates to the lumen of the seminiferous tubules and seeds the calcification 8. A review of the literature showed that the true incidence of TM ranges from In our study, we found the prevalence of TM among pediatric patients with inguinoscrotal affections to be 0.

There is no consensus regarding the predictive value of TM for the appearance of testicular germ cell tumors. TM has been shown to be correlated with conditions such as atrophic testis; varicocele; testicular torsion; sympathetic nervous system calcifications; cerebral calcifications; pseudohermaphroditism; Down's syndrome; Klinefelter's syndrome; cystic fibrosis; germ cell tumors; and carcinoma in situ 9. Otite et al. The authors found that 54 1. Long-term follow-up evaluation of such children is therefore a priority In the present study with pediatric patients, the undescended testes were all located at the inguinal region.

We found that 3. We observed a significant association between retractile testes and TM Patients with cryptorchidism had an increased risk of testicular microlithiasis provided in 36 times. Patients with retractile testicle this risk was increased by almost 10 times. Conversely, patients with inguinal hernia have the risk to present with testicular microlithiasis extremely reduced.

With regard to patients with testicular hypotrophy, the fact that the single carrier of this disease, in this study, be provided with testicular microlithiasis suggests that this result must be considered with some reservation.

The relative risk of These data suggest that these subjects with retractile testes or cryptorchidism may be evaluated with ultrasound scan. The co-occurrence of TM with testicular tumors was not found in this study. The exact relationship between TM and infertility remains unknown. Such patients can also present a significant reduction in sperm motility, resulting in impaired sperm migration and contributing to male infertility 7.

In contrast, infertility in patients with TM has been shown to be secondary to testicular dysgenesis and other concomitant testicular abnormalities 4. This study group consisted of pediatric patients, so no association with infertility could be extracted from this study. There is no consensus regarding proper follow-up of patients with TM. Ultrasound periodicity is every three to six months or annually, being indicated more often in patients presenting focal lesions within the testicular parenchyma and undergoing testicular biopsy 11, The children evaluated in the present study with TM, underwent annual follow-up evaluations with physical examination and ultrasound scan at the Pediatric Surgery Outpatient Clinic.

In agreement with the literature on the association of TM with germ cell tumors, we emphasize the importance of long-term follow-up of these subjects. Testicular microlithiasis TM was a rare condition and occurred in 0. TM had a significant association with cryptorchidism, retractile and hypotrophic testis.

As this study is composed of a pediatric population no correlation with infertility could be extracted. The co-occurrence of TM with testicular tumors was not found. Incidence of testicular microlithiasis. Testicular microlithiasis: imaging appearances and pathologic correlation. Testicular microlithiasis is associated with testicular pathology. Testicular microlithiasis identified ultrasonographically in Japanese adult patients: prevalence and associated conditions.

Scrotal calcification: ultrasound appearances, distribution and aetiology. Br J Radiol. Testicular calcification and microlithiasis: association with primary intra-testicular malignancy in 3, patients. Eur Radiol. The incidence and significance of testicular microlithiasis in a subfertile population. Bilateral testicular microlithiasis predicts the presence of the precursor of testicular germ cell tumors in subfertile men.

J Urol. Significance and management of testicular microlithiasis. Arch Esp Urol. Multi-institutional study of testicular microlithiasis in childhood: a benign or premalignant condition? Is there an increased incidence of contralateral testicular cancer in patients with intratesticular microlithiasis? Am J Roentgenol. Testicular microlithiasis: Is it a benign condition with malignant potential?

Eur Urol. Husmann DA. Cryptorchidism and its relationship to testicular neoplasia and microlithiasis. Campbell HE. The incidence of malignant growth of the undescended testicle: a reply and re-evaluation. Correspondence: Robson Azevedo Dutra Av. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Services on Demand Journal.

Introduction Testicular microlithiasis TM is rare. There is evidence that TM is a precursor of testicular germ cell tumors 1,2 and that it is associated with infertility 3.

Methods Between January and January , we evaluated, prospectively children ranging from 1 to 15 years mean age: 7, 5. Results Among the children evaluated, patients 8. Conclusions Testicular microlithiasis TM was a rare condition and occurred in 0.

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Clinical importance and prevalence of testicular microlithiasis in pediatric patients 1. Involved in the design, collect of data and helped to draft the manuscript. METHODS: Between January and January , we evaluated, prospectively children ranging from 1 to 15 years with inguinoscrotal affections with a high-frequency ultrasound system, which employs a MHz transducer. Testicular microlithiasis was found in 5 children with cryptorchidism 3. The children with testicular microlithiasis were submitted to annual physical examinations and ultrasound evaluations. The association with cryptorchidism, retractile and hypotrophic testis was significant. Testicular microlithiasis TM is rare.

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