Hypoplasia of testicles: diagnosis, treatment and prognosis

Hypoplasia of testicles represents a hypoplasia of one or both male gonads( testicles).In case the testicle size does not exceed two centimeters in length, one can speak about this pathology.

As a rule, this disease is diagnosed at an early age, because it has an innate cause. Sometimes it is detected in adult men, which is associated with insufficient diagnosis of it at an early age and a characteristic decrease in libido and basic sexual functions, which are actively being paid attention to adults in the first place.

Hypoplasia testes - it pathology, is to reduce the size( underdevelopment) of one or both testicles

General characteristics and causes of pathology

The main functions of the testicles in the male body are the production of spermatozoa and testosterone. The first are necessary for the fertilization of the ovum, the second is responsible for the entire complex of male sexual characteristics and sexual behavior that distinguishes a man. With

Causes of testicular hypoplasia:

• disorders at the genetic level( congenital changes in chromosomes);
• infringements of a fetal development( traumas, virus diseases of mother at pregnancy, an intrauterine defeat of a fruit, an intoxication, including an irradiation, smoking, a sun deck, heavy gestoses).

Clinical manifestations of testicular hypoplasia

Depend on the age in which they pay attention to this pathology. As already mentioned above, this disease, being congenital, is manifested already at the earliest age by a purely visual underdevelopment of one or both testicles in size. Other complaints before the puberty crisis in the period of adolescent puberty may not be. It is necessary for doctors to examine and palpate the attention to the size of the testicles and to measure them with the age norm.

Decreased potency, lack of sexual interest, decrease and( or) lack of erection may be symptoms of hypoplasia

In adults, the main manifestations of testicular hypoplasia are:

• male infertility;
• female hair type;
• delay in sexual development( as a consequence of a lack of development of the male sex hormone);
• gynecomastia( enlargement of mammary glands);
• obesity;
• small penis( up to 5 cm) and small scrotum( up to 2.5 cm);
• decreased potency, lack of sexual interest, decreased and( or) lack of erection;

Classification

Single-sided and bilateral hypoplasia is distinguished.

1. One-sided hypoplasia is diagnosed easier, since it is early to draw attention to the difference in size between the two testicles. In this case, it manifests itself clinically much later and is more erased, since a healthy testicle can partially take on the functions of the affected one.
2. Double-sided hypoplasia .If it is missed and not detected at an early age, it manifests itself as a full spectrum of pathological symptoms from the inability to conceive a child to a decrease in libido( sexual desire) and underdevelopment of male sexual characteristics( lack of growth of beard, mustache, development of gynecomastia).

It is important to pay attention to the fact that testicular hypoplasia can be combined with a pathology such as cryptorchidism( not a testicle descent into the scrotum), which is also congenital. When diagnosing "cryptorchidism" it is necessary to carry out a complex of examinations to exclude concomitant hypoplasia.

Diagnostics

For the diagnosis of testicular hypoplasia, a full range of examinations are used, including careful collection of anamnesis, examination, palpation, laboratory and functional research methods.

The patient is required to find out whether or not his immediate family genetic and endocrine disorders how the pregnancy of his mother, whether she had in this period of poisoning, infectious diseases or injuries? Has the mother abused her pregnancy with smoking or alcohol?

To diagnose abnormalities in testicular size used

testikulometr When external inspection pay attention to:

1. scrotum dimensions( normally it is necessarily larger than 2.5 cm)
2. External matching between two eggs and their sizes( in normal testis is greater than 2 cm in length and4 cm in diameter).
3. The size of the penis( normal length is not less than 5 cm).
4. Visual size of mammary glands and fatty deposits.

For laboratory confirmation of the diagnosis, the following is used:

• blood test for testosterone level( always lowered with hypoplasia);
• spermogram( determine the total volume of ejaculate, the number and mobility of spermatozoa, their ability to fertilize the egg).

Treatment

approach to therapy depends on the form of the disease and the patient's age:

Unilateral hypoplasia

When unilateral lesion childhood used expectant management. The patient is regularly observed by a urologist and endocrinologist. During puberty, they pay attention to how actively a healthy testicle takes on the functions and whether correction of the production of the male sex hormone is required. Often, no additional action is taken, limited only by observation.

If it turns out that stimulation is necessary, hormonal drugs are used in minimal doses, imitating natural sexual maturation. The doctor may choose to treat gonadotropic hormones that stimulate the natural development of the testis: human chorionic gonadotropin, follicle-stimulating hormone. Specific treatment regimens and dosages can be recommended only by a specialist. If after a complete examination the doctor comes to the conclusion that stimulation of the development of the testicle is useless, low doses of testosterone preparations are prescribed, followed by an increase in the amount of puberty. Such therapy will be lifelong.

Read more: stimulating therapy chorionic gonadotropin

correctly selected hormone therapy in each individual case can only urologist

adult men with inadequate testicular function recommend testosterone drugs, dosage regimen, and doses are selected specialist. Since men feel psychologically uncomfortable because of visual differences in testicle size, surgeons perform plastic surgery inserting an artificial implant. Atrophy organ is usually removed.

Bilateral hypoplasia

When bilateral hypoplasia development of secondary violations often leads to absolute sterility, and therefore requires mandatory medical actions.

Principles of treatment do not differ from those for unilateral hypoplasia.

• adolescents, with the prospect of restoring testicular functions - gonadotropic hormones;
• for adolescents, if recovery prospects are unlikely - testosterone preparations;
• adults - testosterone preparations, most often for life.

In the 70-80s of the last century Soviet physicians developed the testicle transplantation technique, but it was not widely used not only because of difficulties in obtaining a transplant, but also because of the relatively short( 10-15 years) effect. Improvement of hormone therapy methods made such operations extremely rare.

Forecast

With early diagnosis, constant dynamic observation and proper treatment of unilateral testicular hypoplasia, it is possible to restore sexual function, fertility and avoid serious complications. In some cases, it does not require any additional measures, since a healthy testicle completely copes with the function of producing testosterone and the formation of spermatozoa.

With bilateral hypoplasia of the testicles, much depends on the severity of the lesion and early diagnosis. If the disease is started, the full atrophy of the testicles may develop, which in turn is a threat to the development of organ oncology. With timely treatment, partial restoration of sexual function is possible. In this case, as a rule, long or permanent hormone replacement therapy is required.

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