Clinicopathological Study of Cryptorchid Testis.

Arunkumar, R (2008) Clinicopathological Study of Cryptorchid Testis. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION : Cryptorchidism contributes the most common genital problem, and one of the most common overall problem encountered in pediatric surgical practice. Cryptorchidism literally means ‘hidden testis’. The term is derived from greek word ‘Kryptos’ and ‘Orchis’ meaning ‘hidden’ and ‘testis’ respectively, and refers to the absence of testis from the scrotum. Although some interchangeably call a testis ‘cryptorchid’ or ‘undescended’, the terms are not synonymous, because cryptorchid testis may also be ‘ectopic’, or ‘absent’, while undescended testis typically testifies a testis which is arrested anywhere in the normal course of its descent from the intraabdominal position to the scrotal position. AIM : To evaluate the histopathological changes in undescended testes with relation to age and location of the testis in testicular biopsies taken during orchiopexy, which can be helpful to prognostigate on future fertility, and also to look for the presence or absence of intra-tubular germ cell neoplasia. MATERIALS AND METHODS : This prospective study was done from October 2005 to March 2007 over a period of 18 months, in the Department of Pediatric surgery with the assistance of the Department of Pathology the Institute of Child Health and Hospital for Children, Madras Medical College, Chennai. During the above period, testicular biopsies in cases of undescended testes, either unilateral or bilateral undergoing orchiopexies were done on 21 children with 28 biopsy specimens, varying in age from 10 months-10 years. Inclusions criteria : All cases of Undescended testis Exclusive criteria : Retractile and Ectopic testis. The specimens were fixed in Bouin’s solution (saturated aqueous picric acid 75 ml. 40% formaldehyde-25ml, and glacial acetic acid-5ml) for atleast 6 hours for complete fixation, and subjected for histopathological examination. CONCLUSION : In our histopathological study of testicular biopsies at the time of orchiopexy, it though showed that all the types of testicular lesions are present in all locations from the intraabdominal to the canalicular region, these changes start occurring as early as 1 year of life and even earlier for eg. (10 months in one child in our study) with more severe lesion type. Therefore the generally recommended timing of orchiopexy now being as 1 year can be reduced even to a still further lower age group. Classification of prepubertal testis by their histologic type could make it possible to grade the prognosis with regard to fertility in a large numbers of patients who undergo Orchiopexy at an earlier age. Such studies of prepubertal cryptorchid biopsies comparing them with post pubertal testicular biopsies in laterlife a larger number of cases definitely will help in predicting future fertility. Also in prepubertal cryptorchid testicular biopsies, it is also possible look for the presence of intra-tubular germ cell neoplasia.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Cryptorchid Testis ; Clinicopathological Study.
Subjects: MEDICAL > Paediatric Surgery
Depositing User: Kambaraman B
Date Deposited: 28 Jul 2017 02:58
Last Modified: 28 Jul 2017 02:58
URI: http://repository-tnmgrmu.ac.in/id/eprint/2287

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