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Old 08-06-2012
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Question Why do we do Orchiopexy?

An 8-month-old boy undergoes an orchiopexy for a right-sided undescended abdominal testis. The left testicle was preperly descended at birth. Which of the following statements about this patients condition is true?

A- Orchiectomy of the right testicle would eliminate the risk of testicular cancer.
B- Orchiopexy is necessary to ultimately allow normal fertility.
C- Orchiopexy is primarily performed to allow palpation of the testes.
D- Orchiopexy is unnecessary and is done for cosmetic reasons.
E- Orchiopexy does not reduce the risk of testicular cancer.
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I think the answer is C.
That way you can keep an eye on it for any changes.
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Quote:
Originally Posted by step_enhancer View Post
Please help me with this question

Thanks
I think its either B or E. But I KNOW FOR A FACT that even with surgery the risk of cancer does not reduce. So, I think its E.

Seems like u, me and Novobiocin are doing Paeds KAPLAN QBank. I just did the first 2 blocks of Paeds.
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I think its E..........
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Quote:
Originally Posted by Nouman View Post
I think its either B or E. But I KNOW FOR A FACT that even with surgery the risk of cancer does not reduce. So, I think its E.

Seems like u, me and Novobiocin are doing Paeds KAPLAN QBank. I just did the first 2 blocks of Paeds.
So how are u finding paeds in kaplan qbank ?
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Quote:
Originally Posted by step_enhancer View Post
So how are u finding paeds in kaplan qbank ?
My first block went so bad t! Worst score EVERRR!!! But my second block went sooo muchhhh better and I was happy with the scores. Now on third block and I think its going fine. But I am not much worried about the scores in the Qbanks. Using it like a Text book.I have a very slow speed while attempting Qbanks.. 10 Q/Hr!! To add fuel to the fire, I think i have undiagnosed ADD!!

How about u ?!
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E- Orchiopexy does not reduce the risk of testicular cancer.
orchiopexy in this case should be between 6-12 months. if it's discovered later or after 12 months treat with orchiectomy to avoid risf for cancer, but orchiopexy by it self dosen't decrease the risk

Last edited by alex85; 08-06-2012 at 10:33 AM.
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Indications for surgical correction of cryptorchidism

Quote:
Facilitation of testicular self-examination for testicular cancer
  • Males with undescended testis are 40 times as likely to develop testicular cancer as males without undescended testis.[31] Ten percent of testicular cancer cases involve patients with undescended testis.[32, 33]
  • Recent studies have shown that prepubertal orchiopexy reduces this risk.[34, 35]
  • Clearly, the ability for patients to perform testicular self-examination with the testes in the scrotum is a benefit of surgery.
  • The location of the undescended testis affects the relative risk of testicular cancer. Up to 50% of malignant testicular tumors associated with cryptorchidism involve intra-abdominal testes.[36, 37]
  • Seminoma is the most common malignant tumor type associated with cryptorchidism.[38]
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Quote:
Originally Posted by step_enhancer View Post
An 8-month-old boy undergoes an orchiopexy for a right-sided undescended abdominal testis. The left testicle was preperly descended at birth. Which of the following statements about this patients condition is true?

A- Orchiectomy of the right testicle would eliminate the risk of testicular cancer.
B- Orchiopexy is necessary to ultimately allow normal fertility.
C- Orchiopexy is primarily performed to allow palpation of the testes.
D- Orchiopexy is unnecessary and is done for cosmetic reasons.
E- Orchiopexy does not reduce the risk of testicular cancer.

why not A ?????? i always read the testes should be removed to decrease the risk of CA . infact i also read that the other normally descended testes is also removed as it also has a high risk of developing CA ....

and how does Ochiopexy ( surgical removal on undescended testes ) allow palpation when it is surgically removed
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Answer is C ....

Thanks everyone its clear now
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Quote:
Originally Posted by Novobiocin View Post
Quote:
Facilitation of testicular self-examination for testicular cancer
  • Males with undescended testis are 40 times as likely to develop testicular cancer as males without undescended testis.[31] Ten percent of testicular cancer cases involve patients with undescended testis.[32, 33]
  • Recent studies have shown that prepubertal orchiopexy reduces this risk.[34, 35]
  • Clearly, the ability for patients to perform testicular self-examination with the testes in the scrotum is a benefit of surgery.
  • The location of the undescended testis affects the relative risk of testicular cancer. Up to 50% of malignant testicular tumors associated with cryptorchidism involve intra-abdominal testes.[36, 37]
  • Seminoma is the most common malignant tumor type associated with cryptorchidism.[38]
so why not A
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Quote:
Originally Posted by Hitman View Post
why not A ?????? i always read the testes should be removed to decrease the risk of CA . infact i also read that the other normally descended testes is also removed as it also has a high risk of developing CA ....

and how does Ochiopexy ( surgical removal on undescended testes ) allow palpation when it is surgically removed
Wikipedia "The most common type of testicular cancer occurring in undescended testes is seminoma.It is usually treatable if caught early, so urologists often recommend that boys who had orchiopexy as infants be taught testicular self-examination, to recognize testicular masses and seek early medical care for them. Cancer developing in an intra-abdominal testis would be unlikely to be recognized before considerable growth and spread, and one of the advantages of orchiopexy is that a mass developing in a scrotal testis is far easier to recognize than an intra-abdominal mass"

and i think u got the terms mixed between orchiopexy and Orchiectomy.

Orchiopexy (or orchidopexy) is a surgery to move an undescended testicle into the scrotum and permanently fix it there
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Quote:
Originally Posted by Nouman View Post
I think its either B or E. But I KNOW FOR A FACT that even with surgery the risk of cancer does not reduce. So, I think its E.

Seems like u, me and Novobiocin are doing Paeds KAPLAN QBank. I just did the first 2 blocks of Paeds.
I dont know man ,my paeds block were worst of all ,its heart breaking when you r about finish the qbank .well shi* happens.
hey i take the same time as u 1 hour for 10 Qs haha ,i guess its good to do it well .
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Quote:
Originally Posted by Hitman View Post
why not A ?????? i always read the testes should be removed to decrease the risk of CA . infact i also read that the other normally descended testes is also removed as it also has a high risk of developing CA ....
Because the choice A is
Quote:
A- Orchiectomy of the right testicle would eliminate the risk of testicular cancer.
It does not say A- Orchiectomy of the right testicle would reduce the risk of testicular cancer.

Quote:
Originally Posted by Hitman View Post
and how does Ochiopexy ( surgical removal on undescended testes ) allow palpation when it is surgically removed
Ochiopexy (Surgery to move an undescended testicle into the scrotum) is not the same as Orchiectomy (surgical procedure to remove a testicle)
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Quote:
Originally Posted by step_enhancer View Post
Wikipedia "The most common type of testicular cancer occurring in undescended testes is seminoma.It is usually treatable if caught early, so urologists often recommend that boys who had orchiopexy as infants be taught testicular self-examination, to recognize testicular masses and seek early medical care for them. Cancer developing in an intra-abdominal testis would be unlikely to be recognized before considerable growth and spread, and one of the advantages of orchiopexy is that a mass developing in a scrotal testis is far easier to recognize than an intra-abdominal mass"

and i think u got the terms mixed between orchiopexy and Orchiectomy.

Orchiopexy (or orchidopexy) is a surgery to move an undescended testicle into the scrotum and permanently fix it there

thanks , yes got the terms mixed.....
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Quote:
Originally Posted by Novobiocin View Post
Because the choice A is It does not say A- Orchiectomy of the right testicle would reduce the risk of testicular cancer.



Ochiopexy (Surgery to move an undescended testicle into the scrotum) is not the same as Orchiectomy (surgical procedure to remove a testicle)

thanks ...... was confused by ochiopexy .......
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Quote:
Originally Posted by step_enhancer View Post
I dont know man ,my paeds block were worst of all ,its heart breaking when you r about finish the qbank .well shi* happens.
hey i take the same time as u 1 hour for 10 Qs haha ,i guess its good to do it well .
I dont mind the 10 questions per hr speed..but I dont know whether I will be able to take the exam in Dec or Jan with this speed!! :| And I forget things very easily. Stressful!! I just started my prep and I am crawling like a snail !

The answer does look like C.Sometimes Steps change your whole concept. I never read cryptorchidism with so much detail before this discussion..Whats Next?! Its related to Cryptococcus ....Do we also call it Fungus Balls?!
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Quote:
Originally Posted by Nouman View Post
I dont mind the 10 questions per hr speed..but I dont know whether I will be able to take the exam in Dec or Jan with this speed!! :| And I forget things very easily. Stressful!! I just started my prep and I am crawling like a snail !

The answer does look like C.Sometimes Steps change your whole concept. I never read cryptorchidism with so much detail before this discussion..Whats Next?! Its related to Cryptococcus ....Do we also call it Fungus Balls?!
If u forget stuff easily then i would suggest u to take exam in few months coz u will forget what u studied long time back.well i m taking exam on 1st October .I am beginning my uworld qbank from 11 or 12 of august .what i have learned from step 1 prep is to take the exam quickly when the things r still fresh in your mind.
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Quote:
Originally Posted by step_enhancer View Post
If u forget stuff easily then i would suggest u to take exam in few months coz u will forget what u studied long time back.well i m taking exam on 1st October .I am beginning my uworld qbank from 11 or 12 of august .what i have learned from step 1 prep is to take the exam quickly when the things r still fresh in your mind.
Few months I just started my prep!! havent even finished one subject. I missed this years match and I have no hopes of catching it. Then why taking the risk of scoring less in haste. I have more than a year to complete step 2 ck,cs and step 3. Being an IMG is so hard at times!!I wish it was easier for IMGs to get residency!
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Quote:
Originally Posted by step_enhancer View Post
An 8-month-old boy undergoes an orchiopexy for a right-sided undescended abdominal testis. The left testicle was preperly descended at birth. Which of the following statements about this patients condition is true?

A- Orchiectomy of the right testicle would eliminate the risk of testicular cancer.
B- Orchiopexy is necessary to ultimately allow normal fertility.
C- Orchiopexy is primarily performed to allow palpation of the testes.
D- Orchiopexy is unnecessary and is done for cosmetic reasons.
E- Orchiopexy does not reduce the risk of testicular cancer.
i think answer has to be E reason 1st since left one is properly descended so boy will grow up with normal fertility and for germ cell tumors Iam not sure > reason its has to be over 15 months to start developing changes so advised is orchidopexy between 6mth to 15mths hence risk remains the same. reason for 6 month is sometime normal descend can take place by 6 month ..and for fertility in undescended one true evidences are still not enough that it would retain fertility.
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Old 08-08-2012
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Correct Answer A.

Quote:
Originally Posted by step_enhancer View Post
An 8-month-old boy undergoes an orchiopexy for a right-sided undescended abdominal testis. The left testicle was preperly descended at birth. Which of the following statements about this patients condition is true?

A- Orchiectomy of the right testicle would eliminate the risk of testicular cancer.
B- Orchiopexy is necessary to ultimately allow normal fertility.
C- Orchiopexy is primarily performed to allow palpation of the testes.
D- Orchiopexy is unnecessary and is done for cosmetic reasons.
E- Orchiopexy does not reduce the risk of testicular cancer.
A. to reduce the risk of cancer. The boy is 8 months old. If orchiopexy is done after 1 year, it does not reduce the risk of cancer and orchidectomy is done instead of orcheopexy
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the answer is C......because the risk of having cancer doesnt decrease.we do orchiopex to reach the testis for examination to detect cancer early
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