对于双侧睾丸无法触及的表型男性儿童，内分泌检查能够可靠地预测“先天性”无睾症。

Endocrine tests in phenotypic children with bilateral impalpable testes can reliably predict "congenital" anorchism.

作者信息

Levitt S B, Kogan S J, Schneider K M, Becker J M, Sobel E H, Mortimer R H, Engel R M

出版信息

Urology. 1978 Jan;11(1):11-7. doi: 10.1016/0090-4295(78)90192-9.

Abstract

Congenital anorchism is a rare condition. Bilateral impa-pable undescended testes are relatively common by comparison. Surgical exploration has been regarded as the final arbiter between anorchism and bilateral cryptorchism. Exploration has not proved completely reliable in making this differentiation. Endocrine studies, particularly the human chorionic gonadotropin (HCG) stimulation test together with measurements of basal plasma gonadotropins, can reliably exclude "functioning" testicular tissue. Eleven fully evaluated and operated cases support this contention. In the specific clinical setting of a normal phenotypic male child with a 46XY karyotype and no müllerian structures palpable on rectal examination, nonfunctioning testes on endocrine testing means congenital anorchism and surgical confirmation is unnecessary. In contradistinction, a positive HCG test would appear to mandate through and extensive surgical exploration.

摘要

先天性无睾症是一种罕见的病症。相比之下，双侧无法触及的隐睾则相对常见。手术探查一直被视为区分无睾症和双侧隐睾症的最终判定方法。但事实证明，探查在进行这种区分时并不完全可靠。内分泌学研究，尤其是人绒毛膜促性腺激素（HCG）刺激试验以及基础血浆促性腺激素的测量，可以可靠地排除“有功能的”睾丸组织。11例经过全面评估并接受手术的病例支持这一观点。在具有46XY核型且直肠检查未触及苗勒管结构的正常表型男童这一特定临床情况下，内分泌检查显示睾丸无功能意味着先天性无睾症，无需手术确认。相反，HCG试验呈阳性似乎需要进行彻底而广泛的手术探查。