Is surgical exploration necessary in bilateral anorchia?

Teo, Alex Quok An; Khan, Abdul Rauf; Williams, Martyn P. L.; Carroll, Daniel; Hughes, Ieuan A.

doi:10.1016/j.jpurol.2012.09.006

Cited by 15 publications

(13 citation statements)

References 15 publications

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“…In such patients, the combination of high gonadotropins, low testosterone levels (even after stimulation), and very low or undetectable levels of anti-Mullerian hormone may preclude any surgical intervention. 19,20 In this specific scenario, we recommend consultation with an endocrinologist to determine the best management on an individual basis since interpretation of these investigations is complex and sometimes inconclusive.…”

Section: Imaging Studiesmentioning

confidence: 99%

Canadian Urological Association-Pediatric Urologists of Canada (CUA-PUC) guideline for the diagnosis, management, and followup of cryptorchidism

Braga

Lorenzo

Romao

2017

CUAJ

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Section: Imaging Studiesmentioning

confidence: 99%

Canadian Urological Association-Pediatric Urologists of Canada (CUA-PUC) guideline for the diagnosis, management, and followup of cryptorchidism

Braga

Lorenzo

Romao

2017

CUAJ

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“…The endocrine tests suggested absent testicular function (low AMH, low to undetectable testosterone, high FSH and luteinizing hormone) so acquired bilateral anorchia was considered (14). In rare cases with persistent gonadal remnants, germ cells have been found in testicular remnants, with a theoretical impact on both assisted fertility and germ-cell neoplasia potential (9,15,16). However, fertility is highly unlikely after such a long time interval since disease onset; even more, others argue that the testicular biopsy as well as the human chorionic gonadotrophin stimulation test have limited therapeutic utility (15,16).…”

Section: Discussionmentioning

confidence: 99%

“…In rare cases with persistent gonadal remnants, germ cells have been found in testicular remnants, with a theoretical impact on both assisted fertility and germ-cell neoplasia potential (9,15,16). However, fertility is highly unlikely after such a long time interval since disease onset; even more, others argue that the testicular biopsy as well as the human chorionic gonadotrophin stimulation test have limited therapeutic utility (15,16). In the case of regression testes syndrome most of the authors agree that the testicular remnants (if any) are not associated with germ line neoplasia (9).…”

Section: Discussionmentioning

confidence: 99%

Vanishing testes syndrome-related osteoporosis and high cardio-metabolic risk in an adult male with long term untreated hypergonadotropic hypogonadism

Cârșote

Căpățînă

Valea

et al. 2016

Arch. Endocrinol. Metab.

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SUMMARYThe male hypogonadism-related bone mass loss is often under diagnosed. Peak bone mass is severely affected if the hypogonadism occurs during puberty and is left untreated. We present an interesting; almost bizarre case of a male with non-functional testes early during childhood and undiagnosed and untreated hypogonadism until his fifth decade of life. Forty six year male is referred for goitre, complaining of back pain. Phenotype suggested intersexuality: gynoid proportions, micropenis, no palpable testes into the scrotum, no facial or truncal hair. His medical history had been unremarkable until the previous year when primary hypothyroidism was diagnosed and levothyroxine replacement was initiated. Later, he was diagnosed with ischemic heart disease, with inaugural unstable angina. On admission, the testosterone was 0.2 ng/mL (normal: 1.7-7.8 ng/mL), FSH markedly increased (56 mUI/mL), with normal adrenal axis, and TSH (under thyroxine replacement). High bone turnover markers, and blood cholesterol, and impaired glucose tolerance were diagnosed. The testes were not present in the scrotum. Abdominal computed tomography suggested bilateral masses of 1.6 cm diameter within the abdominal fat that were removed but no gonadal tissue was confirmed histopathologically. Vanishing testes syndrome was confirmed. The central DXA showed lumbar bone mineral density of 0.905 g/cm 2 , Z-score of -2.9SD. The spine profile X-Ray revealed multiple thoracic vertebral fractures. Alendronate therapy together with vitamin D and calcium supplements and trans-dermal testosterone were started. Four decades of hypogonadism associate increased cardiac risk, as well as decreased bone mass and high fracture risk. Arch Endocrinol Metab. 2016;60(1):79-84

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“…115.31) are most commonly thought to be caused by either a vascular event or torsion late in gestation or early in the antenatal period (Rozanski et al 1996;Smith et al 2007;Pirgon and Dündar 2012;Teo et al 2013). It has also been proposed to be associated with abnormal testicular tubule formation after Sertoli cell differentiation (Mizuno et al 2012).…”

Section: Etiologymentioning

confidence: 99%

“…However, some propose that in the presence of bilaterally nonpalpable testes, the absence or low levels of serum anti-Müllerian hormone and inhibin B is adequate for diagnosis of anorchia. Low testosterone levels before and after hCG stimulation are also appreciated, but not considered necessary for diagnosis (Lee et al 1997;Brauner et al 2011;Teo et al 2013). …”

Section: Diagnosismentioning

confidence: 99%