What do we test for during NIPE testes?
Test for bilateral or unilateral undescended testes which occurs in 2-6% of males at term.
What is undescended testes?
When testes do not descend into the scrotum from the inguinal Canal. This can be one or both
What 6 systems are developed alongside testes
Vertebra, anal, cardiac, tracheo oesphagus, renal and limbs.
If one is underdeveloped, other may be too .
Discuss the A+P of NIPE testes
-sex chromosomes produced at 7 weeks - male XY female xx
Y chromosome has SRY ( sex determining region of Y chromosomes, which stimulates testes determining factor, which stimulate gonads.
- gonads turn into testes, which produce testosterone
- all fetus have Müllerian and wolfarian ducts - testoterone stimulates wolffian ducts to create male genitalia
Discuss risk factors for NIPE testes
Family history of undeveloped genitalia
LBW/SGA
Preterm
Maternal obstetric risk
Pradar willi syndrome
Prune belly syndrome
Describe the visual inspection of the NIPE testes
Ruggae - wrinkles or folds
Penis size and shape
Urethra - hypo/epispadius - has baby PU
Scrotum - size, shape, symmetry
Testicular torsion - dark in colour due to lack of oxygenated blood - needs review urgently
Hydrocele - fluid swelling, need light to illuminate it to ensure it isn’t bowel.
How do you complete the NIPE testes examination?
Hold each side of testes with finger and thumb to check for positioning in scrotum. Ensure to hold one in place when observing other to ensure not to confuse them. Also can examine perineal and inguinal canal
What is a positive referal pathway for NIPE testes and who do we refer to?
-bilateral impalpable testes
Unilateral impalpable testes with or without hypospadius
-unilateral palpable testes not in scrotum with hypospadius
-Disorder of sexual development
ALL URGENT REFERRAL - dr need to confirm no congenital adrenal hyperplasia (large adrenal gland which causes reduced hormonal products)
