Criptorquidia: desde la embriología al tratamiento
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Blanco, S., Gottlieb, S., Grinspon, R., & Rey, R. (2015). Criptorquidia: desde la embriología al tratamiento. Médicas UIS, 28(3), 371–380. https://doi.org/10.18273/revmed.v28n3-2015012

Resumen

La criptorquidia es la anomalía genital más común en el recién nacido varón y a pesar de que su evaluación y tratamiento han progresado con las décadas, siguen existiendo muchas controversias al respecto. En todo niño, el examen físico genital debe buscar la presencia de las gónadas en el escroto, en su ausencia, debe tratar de distinguirse si la anomalía es unilateral o bilateral, definiéndose con la mayor precisión posible la posición de estas y distinguiéndose entre testículo criptórquido, ectópico y retráctil junto con la valoración de la existencia de tejido testicular funcional a través de estudios hormonales. El tratamiento puede ser hormonal o quirúrgico, este último no se recomienda antes del año de edad además corresponde a la terapia más exitosa para reubicar el testículo en el escroto en aquellos pacientes con gónadas en posición inguinal alta, abdominal o en posición ectópica, o en aquellos en los que la terapia hormonal ha fallado. Por otro lado, la terapia hormonal se recomienda en mayor medida cuando las gónadas están en posición inguinal media, baja o escrotal alta. El tratamiento apunta a reducir, aunque no siempre logra evitar los posibles problemas a largo plazo de infertilidad y cáncer de testículo. MÉD UIS. 2015;28(3):371-80.

Palabras clave: Fertilidad. Neoplasia Testicular. Orquidopexia.

 

https://doi.org/10.18273/revmed.v28n3-2015012
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Referencias

Sijstermans K, Hack WW, Meijer RW, van der Voort-Doedens LM. The frequency of undescended testis from birth to adulthood: a review. Int J Androl. 2008; 31:1-11.

Abaci A, Catli G, Anik A, Bober E. Epidemiology, classification and management of undescended testes: does medication have value in its treatment? J Clin Res Pediatr Endocrinol. 2013; 5:65-72.

Ghirri P, Ciulli C, Vuerich M et al. Incidence at birth and natural history of cryptorchidism: a study of 10,730 consecutive male infants. J Endocrinol Invest. 2002; 25:709-15.

Preiksa RT, Zilaitiene B, Matulevicius V et al. Higher than expected prevalence of congenital cryptorchidism in Lithuania: a study of 1204 boys at birth and 1 year follow-up. Hum Reprod. 2005; 20:1928-32.

Agarwal PK, Diaz M, Elder JS. Retractile testis--is it really a normal variant? J Urol. 2006; 175:1496-9.

Hack WW, Sijstermans K, van DJ et al. Prevalence of acquired undescended testis in 6-year, 9-year and 13-year-old Dutch schoolboys. Arch Dis Child. 2007; 92:17-20.

Lee PA, Houk CP. Cryptorchidism. Curr Opin Endocrinol Diabetes Obes. 2013; 20:210-6.

Pastuszak AW, Lipshultz LI. AUA guideline on the diagnosis and treatment of cryptorchidism. J Urol. 2014; 192:346-9.

Dym M, He Z, Jiang J et al. Spermatogonial stem cells: unlimited potential. Reprod Fertil Dev. 2009; 21:15-21.

Rey RA, Grinspon RP. Normal male sexual differentiation and aetiology of disorders of sex development. Best Pract Res Clin Endocrinol Metab. 2011; 25:221-38.

Nation TR, Balic A, Southwell BR et al. The hormonal control of testicular descent. Pediatr Endocrinol Rev. 2009; 7:22-31.

Boisen KA, Kaleva M, Main KM et al. Difference in prevalence of congenital cryptorchidism in infants between two Nordic countries. Lancet. 2004; 363:1264-9.

Hutson JM, Hasthorpe S. Abnormalities of testicular descent. Cell Tissue Res. 2005; 322:155-8.

Zivkovic D, Hadziselimovic F. Development of Sertoli cells during mini-puberty in normal and cryptorchid testes. Urol Int. 2009; 82:89-91.

Bergh A, Söder O. Studies of cryptorchidism in experimental animal models. Acta Paediatr. 2007; 96:617-21.

Hadziselimovic F, Zivkovic D, Bica DTG, Emmons LR. The Importance of Mini-Puberty for Fertility in Cryptorchidism. J Urol. 2005; 174:1536-9.

Rey RA, Grinspon RP, Gottlieb S et al. Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach. Andrology. 2013; 1:3-16.

Brioude F, Bouligand J, Trabado S et al. Non-syndromic congenital ypogonadotropic hypogonadism: clinical presentation and genotype-phenotype relationships. Eur J Endocrinol. 2010; 162:835-51.

Eiholzer U, l’Allemand D, Rousson V et al. Hypothalamic and Gonadal Components of Hypogonadism in Boys with PraderLabhart- Willi Syndrome. J Clin Endocrinol Metab. 2006; 91:892-8.

Bergadá I, Andreone L, Bedecarás P et al. Seminiferous tubule function in delayed-onset X-linked adrenal hypoplasia congenital associated with incomplete hypogonadotrophic hypogonadism. Clin Endocrinol (Oxf). 2008; 68:240-6.

Diamond DA, Borer JG, Peters CA et al. Neonatal scrotal haematoma: mimicker of neonatal testicular torsion. BJU Int. 2003; 91:675-7.

Cohen LE, Radovick S. Molecular basis of combined pituitary hormone deficiencies. Endocr Rev. 2002; 23:431-42.

Silveira LF, MacColl GS, Bouloux PM. Hypogonadotropic hypogonadism. Semin Reprod Med. 2002; 20:327-38.

Jennings RW. Prune belly syndrome. Semin Pediatr Surg. 2000; 9:115-20.

Ferlin A, Zuccarello D, Zuccarello B et al. Genetic alteration sassociated with cryptorchidism. JAMA. 2008; 300:2271-6.

Gottlieb S, Rey RA, Malozowski S. Klinefelter syndrome and cryptorchidism. JAMA. 2009; 301:1436-7.

Bay K, Hartung S, Ivell R et al. Insulin-like factor 3 serum levels in 135 normal men and 85 men with testicular disorders: relationship to the luteinizing hormone-testosterone axis. J Clin Endocrinol Metab. 2005; 90:3410-8.

Josso N. Paediatric applications of anti-Müllerian hormone research. Horm Res. 1995; 43:243-8.

Lee MM, Donahoe PK, Silverman BL et al. Measurements of serum Müllerian inhibiting substance in the evaluation of children with nonpalpable gonads. N Engl J Med. 1997; 336:1480-6.

De Schepper J, Verlinde F, Cortvrindt R et al. Serum inhibin B in normal term-born male and female neonates during the first week of life. Eur J Pediatr. 2000; 159:465-9.

Grinspon RP, Ropelato MG, Bedecarrás P et al. Gonadotrophin secretion pattern in anorchid boys from birth to pubertal age: pathophysiological aspects and diagnostic usefulness. Clin Endocrinol (Oxf). 2012; 76:698-705.

Bougnères P, François M, Pantalone L et al. Effects of an early postnatal treatment of hypogonadotropic hypogonadism with a continuous subcutaneous infusion of recombinant folliclestimulating hormone and luteinizing hormone. J Clin Endocrinol Metab. 2008; 93:2202-5.

Aksglæde L, Petersen JH, Main KM et al. High normal testosterone levels in infants with non-mosaic Klinefelter’s syndrome. Eur J Endocrinol. 2007; 157:345-50.

Bastida MG, Rey RA, Bergadá I et al. Establishment of testicular endocrine function impairment during childhood and puberty in boys with Klinefelter syndrome. Clin Endocrinol (Oxf). 2007; 67:863-70.

Lahlou N, Fennoy I, Carel JC, Roger M. Inhibin B and AntiMullerian Hormone, but not testosterone levels, are normal in infants with nonmosaic Klinefelter Syndrome. J Clin Endocrinol Metab. 2004; 89:1864-8.

Ross JL, Samango-Sprouse C, Lahlou N et al. Early androgen deficiency in infants and young boys with 47,XXY Klinefelter syndrome. Horm Res. 2005; 64:39-45.

Elder JS. Ultrasonography Is Unnecessary in Evaluating Boys With a Nonpalpable Testis. Pediatrics. 2002; 110:748-51.

Nguyen HT, Coakley F, Hricak H. Cryptorchidism: strategies in detection. Eur Radiol. 1999; 9-336.

Siemer S, Humke U, Hildebrandt U et al. Diagnosis of nonpalpable testes in childhood: comparison of magnetic resonance imaging and laparoscopy in a prospective study. Eur J Pediatr Surg. 2000; 10:114-8.

Krishnaswami S, Fonnesbeck C, Penson D, McPheeters ML. Magnetic resonance imaging for locating nonpalpable undescended testicles: a meta-analysis. Pediatrics. 2013; 131:e1908-e16.

Ciaccio M, Rivarola MA, Belgorosky A. Decrease of serum sex hormone-binding globulin as a marker of androgen sensitivity. Correlation with clinical response. Acta Endocrinol (Copenh). 1989; 120:540-4.

Tapanainen J, Martikainen H, Dunkel L et al. Steroidogenic response to a single injection of hCG in pre- and early pubertal cryptorchid boys. Clin Endocrinol (Oxf). 1983; 18:355-62.

Zaccara A, Spagnoli A, Capitanucci ML et al. Impalpable testis and laparoscopy: when the gonad is not visualized. JSLS. 2004; 8:39-42.

Grinspon RP, Ropelato MG, Gottlieb S et al. Basal FollicleStimulating Hormone and Peak Gonadotropin Levels after Gonadotropin-Releasing Hormone Infusion Show High Diagnostic Accuracy in Boys with Suspicion of Hypogonadotropic

Hypogonadism. J Clin Endocrinol Metab. 2010; 95:2811-8.

Wikström AM, Bay K, Hero M et al. Serum insulin-like factor 3 levels during puberty in healthy boys and boys with Klinefelter syndrome. J Clin Endocrinol Metab. 2006; 91:4705-8.

Aksglaede L, Juul A. Testicular function and fertility in men with Klinefelter syndrome: a review. Eur J Endocrinol. 2013; 168:R67-76.

Kollin C, Stukenborg JB, Nurmio M et al. Boys with undescended testes: endocrine, volumetric and morphometric studies on testicular function before and after orchidopexy at nine months or three years of age. J Clin Endocrinol Metab.

; 97:4588-95.

Rey RA. Early orchiopexy to prevent germ cell loss during infancy in congenital cryptorchidism. J Clin Endocrinol Metab. 2012; 97:4358-61.

Pettersson A, Richiardi L, Nordenskjöld A et al. Age at surgery for undescended estis and risk of testicular cancer. N Engl J Med.

; 356:1835-41.

Hadziselimovic F. Cryptorchidism, its impact on male fertility. Eur Urol. 2001; 41:121-3.

Penson D, Krishnaswami S, Jules A, McPheeters ML. Effectiveness of hormonal and surgical therapies for cryptorchidism: a systematic review. Pediatrics. 2013; 131:e1897-907.

Thorsson AV, Christiansen P, Ritzen M. Efficacy and safety of hormonal treatment of cryptorchidism: current state of the art. Acta Paediatr. 2007; 96:628-30.

Esposito C, Caldamone AA, Settimi A, El-Ghoneimi A. Management of boys with nonpalpable undescended testis. Nature Clinical Practice Urology. 2008; 5:252-60.

Hack WW, Sijstermans K, van der Voort-Doedens RN. Correction of Cryptorchidism and Testicular Cancer (Letter). N Engl J Med. 2007; 357:826.

Myrup C, Schnack TH, Wohlfahrt J. Correction of Cryptorchidism and Testicular Cancer (Letter). N Engl J Med. 2007; 357:825-6.

Akre O, Pettersson A, Richiardi L. Risk of contralateral testicular cancer among men with unilaterally undescended testis: A meta analysis. Int J Cancer. 2009; 124:687-9.

Sharpe RM, Skakkebæk NE. Testicular dysgenesis syndrome: mechanistic insights and potential new downstream effects. Fertil Steril. 2008; 89:e33-8.

Batata MA, Chu FC, Hilaris BS et al. Testicular cancer in cryptorchids. Cancer. 1982; 49:1023-30.

Riegler HC. Torsion of intra-abdominal testis: an unusual problem in diagnosis of the acute surgical abdomen. Surg Clin North Am. 1972; 52:371-4.

Skakkebæk NE, Jørgensen N, Main KM et al. Is human fecundity declining? IntJAndrol. 2006; 29:2-11.

Hadziselimovic F, Hocht B, Herzog B, Buser MW. Infertility in cryptorchidism is linked to the stage of germ cell development at orchidopexy. Horm Res. 2007; 68:46-52.

Hadziselimovic F, Hoecht B. Testicular histology related to fertility outcome and postpubertal hormone status in cryptorchidism. Klin Padiatr. 2008; 220:302-7.

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