Anorchia – Symptoms, Causes and Treatment

Anorchism is rare condition, where at birth a boy is born without testes, or only one. A few weeks after the egg is fertilized, an embryo will start to develop its sex organs. In a human male if the testes do not develop within the first 8 weeks, the baby will have female genitalia. A baby will have ambiguous genitalia if the testes are lost between eight and ten weeks (part male and part female genitalia). If, after 14 weeks the testes are lost, the baby will have a normal reproductive system except for testicles.

Symptoms and Causes of Anorchia

Signs that your child may have anorchism, include a lack of secondary sex characteristics, such as; when entering suspected puberty in his early teens there is a lack of penile growth and pubic hair growth, no deepening or breaking of the voice and a lack of muscle mass. The causes of anorchia are not really known.

At the moment intra-uterine torsion is thought to be the most likely cause of anorchia. That is; the cord and veins which attach to the testicles become twisted, and cut off blood flow to the still developing foetus’ testes, so they atrophy (shrink) and die. Bi-lateral congenital anorchia occurs in about 1 in 25,000 males, (bi-lateral means affecting both sides and congenital means at birth). Uni-lateral anorchia affects about 1 in 6,000 males, (Uni-lateral means affecting only one side or teste).

Treatment for Anorchia

Uni-lateral anorchia quite often does not require any therapy or surgical intervention as long as testosterone production and levels are sufficiently enough. In males with bi-lateral congenital anorchia , testosterone treatment must be substituted permanently at the time of suspected puberty so as not to delay or impair normal pubertal development. If left untreated, puberty will never start and will undoubtedly develop into what is known as eunechoidism, (he will be sterile and have excessive long bone growth and a lack of secondary sex characteristics).

In males that have suspected uni-lateral anorchia, a thorough examination must be carried out using sonography, computer tomography, MRT. This is because any undescended gonads have a high rate of malignancy. Exploratory surgery may even be required to determine if there is any undescended teste or wasted gonadal tissue, this is carried out using a procedure called a laparoscopy.

Treatments for both uni-lateral and bi-lateral anorchia include, prosthetic testicle implants (silastic material), hormonal medication and psychological counselling and support. The biggest problem with this condition is infertility. A lack of one testicle usually does not mean a man will be less fertile, as one teste is sufficient if it is normal, for reproductive purposes. As stated previously, a man who has bi-lateral congenital anorchia is sterile, and there is no known cure for this condition.

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