TESTICULAR ATROPHY
TESTICULAR ATROPHY: Excerpt from Differential Diagnosis in Primary Care
The causes of this sign can best be recalled by using the mnemonic
VINDICATE.
V—Vascular conditions bring to mind varicoceles, which cause
atrophy on the side of the dilated veins.
I—Inflammation recalls the atrophy following mumps, orchitis, and
other causes of epidydimo-orchitis.
N—Neoplasms suggest the atrophy that occurs in the estrogen
treatment of prostatic carcinoma.
D—Degenerative disorders suggest the
atrophy resulting from aging.
I—Intoxication should remind one of the atrophy resulting from
chronic alcoholism, Lannec cirrhosis, and hemochromatosis. X-ray exposure
may also produce atrophy.
C—Congenital disorders recall
undescended testes and torsion.
A—Autoimmune and allergic disorders suggest nothing.
T—Trauma reminds one of the atrophy following vasectomy and
accidental ligation of the blood supply during hernia repair.
E—Endocrine disorders suggest the
atrophy of hypopituitarism, Klinefelter syndrome, and other eunuchoidal
states.
Approach to the Diagnosis
The workup of testicular atrophy may require a chromatin analysis,
serum testosterone, follicle-stimulating hormone (FSH) and luteinizing
hormone (LH) levels, and biopsy, but referral to an endocrinologist is the
best way to get this accomplished with accuracy.
Other Useful Tests
-
Sperm count
-
VDRL (syphilis)
-
Serum iron and iron binding capacity (hemochromatosis)
-
Liver biopsy (hemochromatosis)
-
Electromyogram (EMG) (myotonic dystrophy)
-
Urology consult
-
Computed tomography (CT) scan of the brain (pituitary
insufficiency)
Pictures
Book Source Details
- Book Title: Differential Diagnosis in Primary Care
- Author(s): R. Douglas Collins MD, FACP
- Year of Publication: 2007
- Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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