Absence Of Testicular Tissue Research Articles

Clinical findings in 10 horses diagnosed with monorchidism following exploratory laparotomy or standing laparoscopic surgery

SummaryMonorchidism describes the complete absence of one testis and is rare in horses. This study reports the clinical findings in 10 horses diagnosed as monorchids by standing laparoscopy or exploratory laparotomy. Hospital records for all horses undergoing cryptorchidectomy (2000–2016) in four centres were reviewed from which horses diagnosed with monorchidism were identified. Surgery was by either standing flank laparoscopy or an inguinal exploration and subsequent exploratory laparotomy under general anaesthesia. Ten horses were diagnosed as monorchids, five by laparoscopy (one bilateral laparoscopy) and five by laparotomy. Nine horses had a normally descended scrotal testicle, which was also removed at surgery. The right testicle was absent in three horses, and the left testicle was absent in seven horses. Anatomical findings were recorded in each case; the vaginal process was present in all horses, ductus deferens and epididymis were present in 80% of horses and the ligament of the tail of the epididymis and testicular vessels were present in 50% of horses. Laparoscopy allowed easy identification of spermatic structures enabling a prompt diagnosis of monorchidism. In conclusion, when monorchidism occurs, most other associated spermatic structures are likely to be present. A diagnosis of true monorchidism is reliant on hormonal testing and absence of testicular tissue on histopathology and so some of these horses may strictly be somewhere on the spectrum of testicular degeneration. This information is particularly useful in the surgical situation when it is not clear whether the testicle is present or not.

Growth pattern, diet and reproductive biology of the clownfish Amphiprion ocellaris in waters of Pulau Tioman, Malaysia

The growth pattern, diet and reproductive biology of the clownfish Amphiprion ocellaris collected from waters of Pulau Tioman were investigated. The length-weight relationship showed an isometric growth pattern (b = 3) in A. ocellaris. The stomach contents mainly consisted of zooplankton and algae, which showed that the fish is omnivorous and was confirmed by trophic level analysis (2.98 ± 0.29). Fecundity of A. ocellaris ranged from 23-1518 with mean egg count of 582 ± 478, and has positive relationships with body length, body weight, eviscerated weight and ovary weight. The gonads were also described and examined histologically. The ovaries showed 4 stages of maturity, displaying different colours for each stage. The different developments of oocytes were also found in each stage of maturity. The males and non-breeders comprised of both testicular and ovarian tissues. In the males, the testicular tissues were more prominent in the ovotestes, whereas in non-breeders the primary oocytes were more prominent. Absence of testicular tissue in ovaries of females showed that the fish is a protandrous hermaphrodite and sex change may not be reversible. Similar observations have been reported in A. ocellaris of other countries and other Amphiprion species indicating that Amphiprion species show consistency in their reproduction strategy throughout their range.

Current Practice for Cryptorchidism: Survey of Pediatric Urologists

IntroductionWe evaluated current practice patterns in the management and screening of cryptorchidism among pediatric urologists and compared them to the 2014 AUA (American Urological Association) guidelines on cryptorchidism. MethodsA 14-question survey was disseminated to members of the SPU (Society for Pediatric Urology) to assess their current practice patterns. ResultsThere were 187 responses (38.4% response rate) with a notable bimodal distribution in respondent practice years, with 39.3% in practice for 10 years or less and 41.4% in practice for more than 20 years. Despite guideline recommendations against the use of ultrasound, the majority of respondents will use it in cases of obesity or bilateral nonpalpable testes (greater than 50%). In the evaluation for bilateral nonpalpable testes most respondents (greater than 80%) perform an endocrine workup. Nevertheless, 55.1% will proceed with surgical exploration even if the workup indicates absence of testicular tissue. Subgroup analysis revealed those in practice for 10 years or less vs greater than 20 years were more likely to perform 2-stage Fowler-Stephens in cases of short vessels (80.8% vs 58.1%) and to perform transscrotal orchiopexy in cases amenable to that approach (79.5% vs 52%). If examination under anesthesia reveals the testicle in the scrotum, 46.5% still perform orchiopexy, citing concerns the testicle will ascend or parental concerns about the diagnosis. ConclusionsBased on the responses some discordance exists between practice patterns and guideline recommendations. Although surgery may be avoided with endocrine evaluation for suspected anorchia, many respondents will still perform exploration. The evaluation, management and surgical approach in cryptorchidism may be influenced by years in practice.

A 78-Year-Old Infertile Man Presented With Sepsis and Abdominal and Pelvic Masses, A Rare Case of Congenital Adrenal Hyperplasia

ABSTRACT Objective: The condition of 46XX congenital adrenal hyperplasia (CAH) causes a wide spectrum of phenotypic manifestations, ranging from ambiguous genitalia to complete virilization with an absence of testicular tissue. While this condition is usually diagnosed during childhood, rare cases have been diagnosed later in life. Methods: We report the case of an elderly male patient presenting at a tertiary health care facility in the United States with severe CAH. He was diagnosed as a chromosome 46XX phenotypic male with metastatic cervical cancer during a workup for gross hematuria. Results: A 78-year-old infertile male presented with sepsis, abdominal pain, and abdominal and pelvic masses. Imaging studies unexpectedly showed a uterus and an adnexal mass. Karyotype analysis revealed the patient as 46XX. The results of subsequent laboratory analyses were consistent with CAH. Surgical removal of the uterus revealed a cervical adenocarcinoma and a benign ovarian mass. Conclusion: This case highlights t...

Testicular regression syndrome and severe psychiatric disorder - a rare association preventing the optimal management of the endocrine condition

Introduction: Bilateral testicular regression syndrome (TRS) is a very rare condition characterized by the absence of testicular tissue in a genotypic male.

The role of Müllerian inhibiting substance in the evaluation of phenotypic female patients with mild degrees of virilization.

Müllerian inhibiting substance (MIS) is a sexually dimorphic gonadal hormone with proven efficacy in the evaluation of boys with cryptorchidism and children with intersex conditions. We examined the role of MIS determination in the evaluation of 65 phenotypic females with mild virilization. Among the 28 subjects with MIS values elevated above the normal female range, all had abnormal gonadal tissue: ovotestes in 11, testes in 7, dysgenetic gonads in 7, and MIS-secreting ovarian tumors in 3. Among the 37 children with serum MIS in the normal female range, 19 had detectable MIS and 18 had unmeasurable MIS. In the former group with measurable but normal female MIS values, 16 subjects had ovaries, 1 had an ovotestis, and 1 had dysgenetic gonads containing testicular elements. Of 18 children with undetectable MIS values, 16 had ovaries and 2 had ovarian dysgenesis. In this study, elevation of serum MIS above the normal female range was consistently associated with the presence of testicular tissue or MIS- secreting tumors, mandating additional evaluation and surgical exploration. A value within the normal female range in a virilized patient did not exclude dysgenetic testicular tissue or ovotestis, whereas undetectable values were consistent with the absence of testicular tissue.

Is ipsilateral testis mandatory for contralateral testicular deterioration encountered following spermatic cord torsion?

Although deteriorating effects of unilateral spermatic cord torsion are generally accepted, the mechanism remains controversial. An experimental study was performed to evaluate the necessity of testicular and spermatogenetic material for contralateral testicular deterioration following unilateral spermatic cord torsion in rats. The animals were allocated to four groups: control, spermatic cord torsion, subepididymal orchiectomy, and spermatic cord torsion 14 days after subepididymal orchiectomy. The testes were removed on the 14th days and mean seminiferous tubular diameters and mean testicular biopsy scores were determined. Although contralateral testicular deterioration was more pronounced in the presence of testicular tissue, the absence of testicular tissue and/or spermatogenetic material did not prevent its occurrence. This is highly suggestive that autoimmune mechanism does not play a role in contralateral testicular damage following unilateral spermatic cord torsion.

PCR analysis and sequencing of the SRY sex determining gene in four patients with bilateral congenital anorchia

We explored the possibility of a genetic anomaly in the sex determining region of the Y chromosome, SRY gene, known to be equated to the testis determining region. Four patients with bilateral congenital anorchia, absence of testicular tissue, elevated FSH and a lack of testosterone response to human chorionic gonadotrophin stimulation tests were studied. Amplification by polymerase chain reaction of the SRY gene and direct double stranded DNA sequencing were performed with the same primers. The expected 648 basepairs band of SRY was detected in the four DNA samples from patients with bilateral congenital anorchia. Direct sequencing did not show any difference with the previous published sequence. These data suggest that, in the four patients, bilateral congenital anorchia is not related to an anomaly of the opening reading frame sequence of the SRY gene.

Testicular regression syndrome — a pathological study of 77 cases

Testicular regression syndrome is characterized by a rudimentary epididymis and spermatic cord with absence of testicular tissue. Although it has been well-described in the surgical literature, few pathological studies have been performed. We report 77 cases of the syndrome, deriving from a 26-year retrospective review. Typical gross descriptions described several cm of spermatic cord with a small mass of firm, fibrotic tissue at one end; elements of the vas deferens, spermatic artery and venous plexuses were usually present. Histologically, the distal expansion of most of the specimens was composed of dense fibrovascular tissue with no evidence of seminiferous tubules or normal testicular elements. Instead, scattered foci of calcification and brown pigment were present. The finding of dystrophic calcification and haemosiderin deposition, with no evidence of viable testicular tissue, in the presence of relatively normal spermatic cord elements, supports the concept of generally unilateral and occasionally bilateral anorchia secondary to remote infarction. The young age of the patients, coupled with the history of an absent testis from birth, is supportive of in utero damage. These histopathological findings provide support for the concept of in utero torsion of the testis as the basis for the testicular regression syndrome.

Testicular regression ("vanishing testis") syndrome - A pathological study of 77 cases

Testicular regression syndrome is a condition characterised by a rudimentary epididymis and spermatic cord with absence of testicular tissue. Although it has been well described in the surgical literature, few pathological studies have been performed. To characterise the condition more clearly, a retrospective review was made, covering a 25 year period from 1965 to June 1990 at the Adelaide Children's Hospital Department of Histopathology. A total of 77 cases of testicular regression syndrome were found. Typical gross descriptions described several centimetres of spermatic cord with a small mass of firm, fibrotic tissue at one end. Elements of the spermatic cord, i.e. vas deferens, spermatic artery and venous plexi, were usually present. Histologically the distal expansion of most of the specimens was composed of dense fibrovascular tissue with no evidence of seminiferous tubules or normal testicular elements. Instead, scattered foci of calcification and brown pigment were present. Von Kossa staining confirmed the presence of calcium while Perls' and Schmeltzer's staining demonstrated the presence of both ferric and ferrous ions. A few cases included atrophic seminiferous tubules. The finding of dystrophic calcification with evidence of remote haemorrhage with no evidence of viable testicular tissue in the presence of relatively normal spermatic cord elements supports the concept of secondary anorchia resulting from infarction. The young age of the patients, coupled with the history of an absent testis from birth, is also supportive of in ulero damage This histopathologic study provides morphological support for the concept of <i>in ulero</i> torsion of the testis as the basis for the testicular regression syndrome.

Magnetic resonance imaging of the cryptorchid testis

Magnetic resonance imaging was used to evaluate seven patients with undescended testes. In six patients the presence or absence of testicular tissue was predicted correctly prior to surgery. Spermatic cord structures, if present, were accurately visualized in all patients.

Presence of H-Y antigen in female patients with sex-chromosome mosaics and absence of testicular tissue.

H-Y antigen was tested in five women with sex chromosome mosaicism and gonadal streaks. Three patients had a 45,X/46,XY or 46,X,der(Y) and two a 45,X/46,X, der(X) chromosome constitution. All patients were H-Y antigen positive. Lack of testis differentiation in these women may be explained by subthreshold expression of H-Y antigen, different H-Y antigen molecules, and/or different tissue distribution of the chromosome mosaicism.

Autopsy Findings in the Prader-Willi Syndrome

Autopsy findings in two cases of Prader-Willi syndrome were described. Case 1. was a 4–3/12 year-old boy who had hypotonia in the neonatal period, hypogonadism, mental retardation and obesity. Autopsy revealed edema, congestion and focal bleeding in the lung, cardiac hypertrophy, localized degeneration of corpus callosum, nesidioblastosis, fatty liver and absence of testicular tissue. Case 2. was a3–11/12 year-old boy who had hypotonia in the neonatal period, hypogonadism, mental retardation, obesity and recurrent respiratory tract infections. Autopsy revealed multiple thrombosis, pulmonary changes including edema, congestion, focal bleeding and infarcts, cardiac hypertrophy, fatty liver and absence of testicular tissue. These findings were thought to be summarized in the following three categories; 1) terminal changes characterized by pulmonary edema and congestion and cardiomegaly probably due to respiratory failure, 2) aquired changes due to metabolic abnormalities in this syndrome including fatty liver, nesidioblastosis and focal degeneration of the central nervous system; and 3) congenital abnormalities characterizing hypogonadism. (Acta Paediatr Jpn 23(3):289–293 1981)

Carcinoma of the Prostate in the Absence of Testicular Tissue

Carcinoma of the Prostate in the Absence of Testicular Tissue