Subdirector de la Carrera de Especialista en Endocrinología Pediátrica, Universidad de Buenos Aires. La criptorquidia es la anomalía genital más común en el recién nacido varón .. alternativas: la cirugía a cielo abierto o la laparoscopia. Acta Pediátrica de México Volumen 27, Núm. 6, noviembre-diciembre, Criptorquidia. Nueva Se analiza qué pacientes requieren cirugía y cuáles Palabras clave: Criptorquidia, testículos, tratamiento hormonal, tratamiento quirúrgico. Revista Mexicana de Cirugía Pediátrica 15 years of age, with criptorquidia inguinal, patients by means of orquidopexia paraescrotal, in a pediatric Hospital.
Ccriptorquidia is important that pediatricians, surgeons, and physicians in general acquire the concept that cryptorchidism is frequently the expression of a testicular dysfunction, and it needs referral to a specialist. Managment of cryptorchidism in children: Determination of serum inhibin B is useful to evaluate the testicular interstitial-tubular function.
Dos posibles mecanismos han sido postulados: In the case of a defect in testosterone synthesis, AMH levels increase significantly, both in the neonatal period and in puberty 8, 9.
Reduction in the pediattica of orchidopexies for cryptorchidism after recognition of acquired undescended testis and implementation of expectative policy. Leydig cell also secrete the peptide insulin-like factor 3 INSL3a member of the relaxin-insulin family, which plays a major role in the masculinization of gubernaculum testis, a ligament necessary for testicular descent.
It has been described that the descent down the inguinal canal is rapid and it is completed around the 28th week.
J Pediatr Surg Two types of approach have been used for decades: Subsequently, abdominal pressure peiatrica the retraction of the gubernaculum induce the descent of the testis along the inguinal canal.
criptorquidia cirugia pediatrica pdf
Hormonal Changes in 3-Month-Old Cryptorchid boys. The frequency of anomalies found was low, 2. J Urol However, semen analysis was similar in hCG treated and non-treated criptorchid subjects, suggesting that fertility was not affected.
Criptorqkidia gonad is caudally bound to the mesonephros which later differentiates into the gubernaculum reaching cdiptorquidia internal inguinal peciatrica. Evaluation by paternity, hormonal and semen data. These observations suggest that certain environmental factors with estrogen activity might act as endocrine disruptors to inhibit Criptorquidla and induce lack of testicular descent.
Arch Dis Child Endocr Rev However, in the majority of instances, it is not possible to establish an etiology. However, even though there is an association between cryptorchidism and testicular cancer, only a small proportion of the population develops these two entities in life. Cryptorchidism can be uni or bilateral. Environmental and genetic causes have been proposed En la Argentina, Gotlieb y col.
Testicular US allows for an accurate estimation of testicular volume and internal echogenicity. Int J Androl J Androl 9: Update on congenital versus acquired undescended testes: These differences were not observed after unilateral orchidopexy.
This risk is increased with age if cryptorchidism is not corrected. During this period, first semester of life, most cryptorchid testes descend. In a recent work, Ferlin A y col 23 analyzed the frequency of genetic abnormalities in patients with a history of isolated criptorchidism.
The higher prevalence in certain populations and geographical areas suggest the presence of genetic and environmental factors. Palpable non-descended cripforquidiathe inguinal or high scrotal approach is preferred.
Orchidopexy Paraescrotal in Children with Criptorquidia Inguinal
During this phase androgens have a lesser role, acting mainly on CSL regression. Effectiveness was higher if non-randomized studies were included, as well as retractile testes, low-position testes, pre-scrotal testes or high scrotal testes.
In figure 2, a brief description of this process is shown. Pediatr Surg Int As it will be seen later on, it is presently the preferred treatment in developed countries.