Testicular hypoplasia is a congenital underdevelopment of one or both testicles, leading to androgen deficiency. Hypoplasia of the testicles is accompanied by a decrease in the size and asymmetry of the scrotum, small penis size, violation of puberty, pseudogynecomastia, decreased libido, impotence, male infertility. The diagnosis of testicular hypoplasia is based on examination and palpation of the scrotum, results of ultrasound of the scrotum organs, spermogram, and studies of the level of total and free testosterone. Treatment of testicular hypoplasia includes hormone replacement therapy, prosthetics of an underdeveloped testicle, and transplantation of a donor organ.
Hypoplasia of the testicles occurs as a result of a violation of their formation at the early stages of embyrogenesis. The earlier the damage occurred, the more pronounced the degree of the defect. Normally, the sex glands develop from two germ structures: the wolf and Muller ducts at the indifferent stage of gestation. Normally, gonad differentiation occurs in accordance with the genetic sex of the fetus.
Predisposing factors to the development of testicular hypoplasia are the pathological course of pregnancy, hormonal imbalance, the influence of various teratogenic factors on the pregnant woman's body, and damage to the child's Central nervous system during heavy labor. Sometimes hypoplasia of the testicles is combined with hypoplasia of other endocrine organs.
Hypoplasia of the testicles is often asymptomatic and is detected accidentally when the patient goes to the urologist about a infertile marriage. When hypoplasia of the testicles, the scrotum looks less than normal due to the reduction in the size of one or both glands, ranging from 0.5-0.7 to 2.5 cm. hypoplasia of the appendages of the testicles and the prostate is also characteristic.
The main sign of testicular hypoplasia is a violation of the hormonal background; the severity of the pathology is determined by the degree of decrease in testosterone. With unilateral hypoplasia of the testicles, due to compensatory mechanisms, the second healthy gland takes over some of the functions, so the level of hormones changes slightly. At the same time, a healthy testicle noticeably increases in size. With a small degree of hypoplasia of the testicles, spermatogenesis proceeds normally, and a man is able to conceive a child on his own.
Testicular hypoplasia occurs in alcoholic embryophetopathy, hypogonadism, adrenal tumors (corticosteroma), various syndromes (Kleinfelter, Alstrom-Olsen, Shereshevsky-Turner, bard-bidl, etc.), pituitary nanism, epispadias. Hypoplasia of the testicles can lead to serious consequences: male infertility, atrophy and degeneration of the testicles, the development of prostatitis, malignant tumors (testicular cancer).
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