Testicular hypoplasia is a phenomenon of insufficient development of one or two testicles, which has a congenital character. This disease subsequently leads to androgen deficiency. Signs of underdevelopment are asymmetry of the scrotum, a decrease in its size, a small penis, puberty dysfunction, impotence, infertility, decreased libido and pseudogynecomastia.
The content of the article:
Causes of testicular hypoplasia
Symptoms of testicular hypoplasia
Diagnosis of testicular hypoplasia
Treatment
Testicular hypoplasia
Congenital malformations with testicular hypoplasia include anarchism (polyorchism) — violation of quantity; cryptorchidism or ectopia — violation of position; hypo- and aplasia — violation of structure.
This disease occurs in a small percentage of newborns — up to 7% of boys may have unilateral (when the second testicle is developed normally) or bilateral hypoplasia (when both testicles reveal deviations from the norm in size).
Diagnosis of the disease includes examination by a specialist, palpation of the scrotum, ultrasound tests and spermograms, as well as analysis of total and free testosterone.
Causes of testicular hypoplasia
The normal development of testicular testicles, or testicles, is when paired male sex glands adequately perform two functions: the production, ensuring the maturation of sperm (reproductive function) and the erection of testosterone (endocrine function). Since the testicles are responsible for the development of sexual development and the realization of a man, the development of his reproductive system depends on their health. Healthy testicles should be placed in the scrotum and separated by a specific septum, their size should be about 4-5 cm in length, 2-3 cm in width, and the weight should be from 20 to 30 grams. All these conditions allow the testicles to function normally, because this is how it is possible to maintain an adequate temperature regime — 32 degrees, which is a prerequisite for spermatogenesis. A healthy testicle consists of lobules, covered with several shells and filled with seminal tubules of a straight and convoluted type.
A developmental disorder — hypoplasia in men — is a deviation from their normal formation at the stage of the embryonic period. If the disease began to manifest itself at an early stage, then after birth the boy will have pronounced manifestations of the disease. The wolf and Muller ducts form the male sex glands, which makes the testicles an active endocrine organ even at the stage of embryo development. Under the influence of the hormonal background produced during the development of the testicles, the seminal vesicle and the vas deferens are formed.
The development of primary sexual characteristics also occurs in the puberty period, it ends at about 17-18 years of age.
Hypoplasia, therefore, occurs due to genetic abnormalities, abnormalities in the number or structure of chromosomes, damage to genes. A prerequisite for this may be the pathology of pregnancy, a violation in the balance of the mother’s hormones (for example, due to the use of estragens or progestin medications during pregnancy). In addition, the process of severe childbirth, which provoked a violation in the work of the central nervous system, can also affect this.
Of course, the underdevelopment of the testicles can be caused by a violation in the endocrine system and in the work of individual organs — for example, the thyroid gland. Autoimmune diseases and family heredity can also affect the underdevelopment of the testicles.
Symptoms of testicular hypoplasia
Signs of hypoplasia in boys are often simply absent, and in most cases it is detected only in adult men after going to a urologist, which most often occurs due to problems with conceiving a child.
The external manifestation of hypoplasia includes a deviation in the size of the scrotum from the norm, since one or both glands are underdeveloped. Separately, there may be hypoplasia of the prostate and appendages.
A symptom of hypoplasia is a violation of the endocrine background. The degree of manifestation of the problem is checked by an analysis of the level of testosterone reduction. If hypoplasia is unilateral, then usually the second testicle takes over the functions of an underdeveloped one, which means a slight change in the general characteristics of the hormonal background. This phenomenon is manifested by an increase in the size of a healthy testicle, but with this form of the disease, a man is quite capable of conception, since sperm production occurs normally.
Bilateral hypoplasia is characterized by the following symptoms: acute androgen deficiency, dysfunction and disorders of puberty; impotence and decreased libido; eunuchoidism, insufficient sperm production.
Diagnosis of testicular hypoplasia
A thorough diagnosis is carried out, which the disease requires, treatment can include a very variety of techniques, so the degree of dysfunction should be clearly defined. A hormone specialist or an andrologist conducts an examination, studies the patient’s anamnesis, palpates the scrotum, assessing the characteristics of the size, symmetry of the testicles.
The tests include ultrasound techniques, laparoscopy, which effectively show themselves for diagnosis.
If the problem is present in an adult, a spermogram analysis is assigned to him, which reveals the degree of total and active testosterone in the blood serum sample taken. Genetic analysis can help identify problems with the patient’s chromosomes or genetics.
A differential diagnosis is also prescribed in order to separate hypoplasia of the right or left testicle from possible ectopia, cryptorchidism, monarchism.
Treatment
Basically, methods are used to eliminate the problem of underdevelopment of the testicles, which include taking hormonal medications, hormone stimulation therapy. Depending on whether unilateral or bilateral hypoplasia is diagnosed in the patient, specific treatment is prescribed, which is accompanied by constant monitoring of the patient’s health status.
If the examination and diagnosis show that one of the testicles has completely assumed the functions of an underdeveloped one, hyperplasia is treated with surgical removal of this testicle. The procedure is called orchiectomy, after which, if the patient wants it, aesthetic surgery, prosthetics or implantation of an artificial testicle can be performed.
In the event that there is an imbalance in the hormonal background of the patient with hypoplasia, a donor testicle transplant or an alloplastic transplant is prescribed.
