China
Africa
Explore chapters and articles related to this topic
Case 34
Published in Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta, Clinical Cases, 2021
Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta
Testicular size is relevant in any case where pubertal progress is important and/or a condition that may affect gonadotropin/androgen status. It is done by both inspection and palpation, and, whilst expecting a slight degree of asymmetry, one should find bilateral testes with volumes appropriate for age. The normal volumetric status for an adult male is approximately 20–25 mL. There are age-appropriate scales available for testicular volume linked with pubertal stage of development. The volume can be accurately assessed using equipment called an orchidometer.
Varicocele
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Taha Abo-Almagd Abdel-Meguid Hamoda
Testicular size and consistency should also be examined, and it is critical to determine any testicular atrophy or any volume discrepancy between left and right testicles. Although ultrasonography is more accurate in sizing the testicles, in clinical practice an orchidometer offers reliable measurements of testicular volumes [14].
Male infertility
Published in C. Yan Cheng, Spermatogenesis, 2018
Ryan Flannigan, Marc Goldstein
All patients should receive a general physical exam. Particular focus should be made to body habitus, hair distribution, secondary sex characteristics, and presence of gynecomastia, stature, and midline defects. An abdominal examination should be performed to assess for signs of previous abdominal or inguinal surgical scars. Penile examination should be performed to assess the location of the meatal opening. Scrotal examination should be performed in a warm and comfortable environment to encourage relaxation of the scrotal dartos muscle, making examination easier and more accurate. Locally, we use a heating pad on the scrotum for 2–5 minutes to facilitate scrotal relaxation. The testicles are palpated for size and consistency; we recommend using an orchidometer for accurate assessment of testicular size. The epididymis is palpated for fullness, induration, and tenderness. The spermatic cord should be palpated while the patient is both supine and standing. The vas deferens are palpated bilaterally and the cords are assessed for varicoceles with and without Valsalva upright. If the presence of varicocele is unclear, the patient should be placed supine and reexamined; if a varicocele is present, the cord will collapse when supine and become distended when standing.
Utility of micro-TESE in the most severe cases of non-obstructive azoospermia
Published in Upsala Journal of Medical Sciences, 2020
Before surgery, at least two semen analyses have been performed to confirm azoospermia. Moreover, serum-FSH, LH, testosterone and SHBG concentrations have been analyzed to distinguish between obstructive and non-obstructive azoospermia and to exclude hypogonadism. A physical investigation has been performed measuring testicular volume with an orchidometer, and testicular ultrasonography to exclude scrotal abnormalities such as varicocele, epididymal/testicular cysts, hydrocele, and testicular tumours. Finally, a karyotype has been analyzed in most NOA men, and screening for Y-chromosomal microdeletions carried out as well.
Deep phenotyping of pubertal development in Norwegian children: the Bergen Growth Study 2
Published in Annals of Human Biology, 2023
Petur B. Juliusson, Ingvild S. Bruserud, Ninnie Helen Bakken Oehme, Andre Madsen, Ingvild H. Forthun, Melissa Balthasar, Karen Rosendahl, Kristin Viste, Astanand Jugessur, Lawrence M. Schell, Robert Bjerknes, Mathieu Roelants
The Tanner scales and the timing of menarche are routinely used to assess pubertal development. The British paediatrician James Tanner introduced his eponymous scoring system for assessing the development of secondary sex characteristics in the late 1960s, and it is still widely used today (Tanner & Whitehouse 1976). In girls, the Tanner scale includes five distinct stages of the breast (B1–B5) and pubic hair (PH1–PH5) development. In boys, it includes five stages of genital (G1–G5) and pubic hair (PH1–PH5) development. Testicular volume measured with a Prader orchidometer is also a part of the routine pubertal assessment in boys. Puberty onset is commonly defined by the Tanner stage B2 of breast development in girls, and a testicular volume (TV) larger than 3 mL in boys. Assessment of the Tanner breast stage is prone to subjectivity, as it is mainly based on visual inspection. Overweight and obesity in the paediatric population have also led to increased uncertainty regarding the reliability of Tanner B staging since the presence of fat tissue could be misinterpreted as actual breast development, although this concern is more based on clinical experience than on scientific data (Euling et al., 2008). In boys, several studies have shown that the Prader orchidometer systematically overestimates small TVs, probably due to the inability of the instrument to differentiate the actual testicle from its surrounding tissues, e.g. epididymis, scrotal skin, and tunica vaginalis (Al Salim et al., 1995). Although the Tanner scale and the Prader orchidometer are easy to implement in a clinical setting, the need for a more objective classification system for pubertal development is justified. Furthermore, because such an assessment of breast development and testicular volume is based partially on palpation, it may be perceived as being psychologically invasive.
The prevalence and severity of varicocele in adult population over the age of forty years old: a cross-sectional study
Published in The Aging Male, 2019
Huseyin Besiroglu, Alper Otunctemur, Murat Dursun, Emin Ozbek
Between January and October 2014, 465 patients aged 40 or more were enrolled in this cross-sectional study. Institutional review board approval was obtained before the start of the study. All participants signed the informed consent before being enrolled in the study. First, we divided the participants into three groups including unilateral, bilateral, and varicocele-free groups; then varicocele patients were classified into three grades considering the severity of the disease: severe (grade 3 ), moderate (grade 2), and mild (grade 1). We stratified the patients according to age category: 40–49, 50–59, 60–69, and ≥70 years old. For detecting varicocele, the patients were examined in a warm room in supine and standing positions. The spermatic cord was palpated at rest and during Valsalva maneuver. Each side was evaluated using following standard grading system; grade 1, palpable only with Valsalva; grade 2, easily palpable but not visible and grade 3, easily visible. To prevent inter-observer bias, the same experienced physician performed all examinations. Scrotal ultrasound was not delivered to detect varicocele; only physical examination was applied. Testicular size was measured with a Prader orchidometer, which is a chain of 12 solid wooden ellipsoids with volumes of 1–6,8,10,12,15,20, and 25 ml that are visually compared with the size of each testis. We grouped the participants depending on whether their testicular volume was greater than 20 ml or not. We evaluated the testicular consistency by palpation. The consistency was subjectively graded as either soft or normal. All men had testosterone levels as assessed by a peripheral venous serum sample taken between 8:00 h and 10:30 h. Plasma testosterone levels for each subject were measured by automated chemiluminescent microparticle immunoassay; intra-assay coefficient of variability (CV) was 4.4%, and inter-assay CV was 5.2%.