ISSN:1663-2818    

DOI:10.1159/000181046

出版商:S. Karger AG    

年代:1988

数据来源: Karger

ISSN:1663-2818    

DOI:10.1159/000181047

出版商:S. Karger AG    

年代:1988

数据来源: Karger

ISSN:1663-2818    

DOI:10.1159/000181048

出版商:S. Karger AG    

年代:1988

数据来源: Karger

ISSN:1663-2818    

DOI:10.1159/000181049

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

The treatment of the undescended testis still engenders controversy on both sides of the Atlantic. To date, there is still no consensus on how to treat a child with an undescended testis. Some physicians advocate surgical therapy of all children whose testes are not located at the bottom of the scrotum whereas others feel that hormonal therapy should be tried initially on all such boys. The following attempts to provide an objective assessment of each of these two therapeutic modalities, highlighting the current controversies.

ISSN:1663-2818    

DOI:10.1159/000181050

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

A description is given of the role of the gubernaculum testis in the migration of the testis from the intra-abdominal to the scrotal position. The morphological differences in the process between carnivores, ungulates and man on the one hand and rodents on the other are stressed. The importance of gubernacular outgrowth, gubernacular regression as well as the importance of intra-abdominal pressure is emphasized. The effects of some forms of abnormal gubernacular development on testicular descent are described. The hormonal factors possibly involved in the regulation of the gubernacular reaction are evaluated. LH-RH, gonadotropins, AMH and testosterone seem not to be responsible for gubernacular outgrowth but a low molecular weight fraction of a fetal testicular extract, called descendin, is stimulatory to gubernacular cells. There are indications that testosterone plays a role in the initiation of gubernacular regression.

ISSN:1663-2818    

DOI:10.1159/000181051

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

A total of 3,559 boys were examined for cryptorchidism over a 2-year period. At birth, 5.9 % (210/3,534) had one or both testes undescended and at 3 months of age 1.61 % (57/3,534) still had an undescended testis. These figures represent an increase in undescended testis of 40% at birth and 68% at 3 months when compared with figures collected in a similar study in the late 1950s. This increase in cryptorchidism still does not account for the increased number of orchiopexies being performed. Low birthweight was also found to be a risk factor for the presence of an undescended testis.

ISSN:1663-2818    

DOI:10.1159/000181052

出版商:S. Karger AG    

年代:1988

数据来源: Karger

ISSN:1663-2818    

DOI:10.1159/000181053

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

In a series of 545 boys with undescended testis, 91 had bilateral spontaneous descent after the age of 10. Forty-five accepted to take part in an investigation of their fertility based on history, clinical examination, sperm analysis and estimation of serum FSH levels. In the majority, the volume of the testis was below normal and the sperm concentration was below the lower limit of the normal range. It is concluded that late spontaneous bilateral descent of the testis carries a serious risk of later impaired spermatogenesis.

ISSN:1663-2818    

DOI:10.1159/000181054

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

In cryptorchid infants, significantly decreased mean levels of plasma testosterone and luteinizing hormone (LH) were found between the ages of 30 and 120 days. The levels of testosterone and LH were significantly correlated. No significant difference was found between infants with bilateral or unilateral cryptorchidism. After 120 days there was no longer any significant difference between cryptorchid infants and controls. No significant change in plasma follicle-stimulating hormone (FSH) was found. These data suggest that subnormal secretion of LH could be the primary abnormality in a proportion of boys with so-called common cryptorchidism. Our studies using LH-releasing hormone and human chorionic gonadotropin stimulation tests in older infants and children agree with the data obtained by measurement of basal plasma hormone levels during the first months of life. Anti-gonadotroph antibodies were found in the sera of approximately 50% of the cryptorchid children and infants studied, using an immunofluorescence technique. A study of 17 mothers and their infants gave concordant results in 16 pairs, 9 with and 7 without antibodies. This leads us to speculate on the possible role of maternal autoantibodies as a cause of partial gonadotrophin deficiency in the perinatal period and thus of testicular maldescent. As cryptorchidism is a syndrome, these findings do not mean that a similar mechanism is operative in all cases. However, these data do suggest that alternatives to the classical anatomical view of the descent and nondescent of the testes should be considered.

ISSN:1663-2818    

DOI:10.1159/000181055

出版商:S. Karger AG    

年代:1988

数据来源: Karger