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Diagnostic of malposition Testis (undescended Testicle, Cryptorchidism) in Germany

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of Adult and Pediatric Urology, Andrology

The Department of Adult and Pediatric Urology, Andrology offers the full range of services in the areas of its specialization. Men and boys with diseases of the reproductive system can be diagnosed and treated in the medical facility. Doctors also treat infertility and erectile dysfunction. Medical care is provided to men and women with diseases of the urinary system, namely kidneys, ureters, bladder, and urethra. The department is certified as the Prostate Cancer Center by the German Cancer Society (DKG), which indicates the excellent quality of the services provided in this area. The department's urologists have a perfect command of the innovative treatment methods, including holmium laser enucleation of the prostate (HoLEP), photodynamic therapy, and da Vinci robot-assisted surgery. The department employs comprehensively trained and experienced doctors who apply advanced medical achievements in their practice. Each patient is provided with an individual approach, considering their specific needs and wishes.

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Urology Clinic Munich-Planegg Munich

10/10
location_onGermany, Munich

Department of Adult and Pediatric Urology, Andrology

The Department of Urology annually examines more than 750 men with suspected malposition testis (cryptorchidism). The specialists of the department make a detailed evaluation of the location of the testicle and its function, after which they plan an optimal treatment regimen, including hormonal therapy. The department is headed by Prof. Dr. med. Martin Kriegmair, who is a member of the German Society of Urology, as well as of the European and American Association of Urologists.

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University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top medical institutions in Germany for prostate cancer treatment! The department offers the full range of high-precision diagnostics and effective treatment of diseases of the urogenital system, genitals in men and boys. It treats about 3,000 inpatients and 9,000 outpatients with the clinical cases of varying severity every year.

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German medical facilities specializing in prostate cancer treatment! The department offers all types of modern diagnostic and therapeutic services for patients with urologic diseases. Of particular interest is the treatment of urogenital tumors in men and urogynecological diseases. The department also specializes in kidney transplantation, which is carried out within the specialized center. This center is the largest in Germany and Europe and annually demonstrates high treatment success rates. In addition, the department's competence covers the treatment of urological problems in boys of all age groups.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German departments specializing in prostate cancer treatment! The department offers the full range of diagnostics and treatment of the urinary system in men and boys. The department has a long history, rich traditions, and is also a recognized center of excellence in the treatment of all urological diseases. The department specializes in the treatment of malignant urological diseases, reconstructive surgery, pediatric urology, treatment of urinary tract dysfunction and kidney stone disease.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Urology

According to the Focus magazine, the Department of Urology ranks among the top German medical institutions specializing in prostate cancer treatment! The department offers the full range of high-precision diagnostic studies and effective therapeutic options for men with diseases of the genitourinary system. The doctors of the department specialize in the treatment of prostate cancer, benign prostatic hyperplasia, kidney, testicular cancers, urolithiasis, erectile dysfunction and urinary incontinence. There are also excellent qualifications in the field of reconstructive urology.

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German medical facilities specializing in prostate cancer treatment! The department offers the full range of advanced methods of diagnostics and treatment of all genitourinary system diseases, including in children. Of particular interest is the treatment of patients with urinary tract and kidney tumors, kidney stone disease, prostate diseases, treatment of urinary incontinence, andrologic disorders and urological problems in young patients. Since 2010, the department has been certified as the Prostate Cancer Center (certified by the German Cancer Society, recertified in 2016).

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of Adult and Pediatric Urology, Andrology

According to the Focus magazine, the Department of Adult and Pediatric Urology, Andrology ranks among the best departments in Germany specializing in prostate cancer treatment! The department offers the full range of diagnostic and therapeutic services in the fields of its expertise. The department's medical team specializes in the treatment of diseases of the urinary tract in women and men, as well as in the treatment of pathologies of the reproductive system in adult men and children, andrological diseases in men. The primary focus of the clinical practice of the department's doctors is medical care for patients with kidney, bladder, ureteral, urethral, prostate, testicular and penile cancers. The department's specialists keep pace with medical innovations, so most surgical interventions are performed using sparing laparoscopic techniques that do not require large incisions in the skin and soft tissues. To treat prostate cancer, doctors successfully use robot-assisted prostatectomy with the da Vinci surgical system. This intervention has many advantages over classical surgery and is available only in the best hospitals in the world. In addition, the department's doctors demonstrate excellent results in the treatment of kidney stone disease, urinary incontinence and pelvic organ prolapse. A specially trained team of doctors has been formed for the treatment of urological pathologies in children. Of particular interest is the correction of congenital genitourinary anomalies in young patients.

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Urology

According to the Focus magazine, the Department of Urology ranks among the top medical institutions in Germany specializing in prostate cancer treatment! The department offers the full range of diagnostics and treatment of urinary tract diseases in men. Of particular interest are kidney transplantation, treatment of benign and malignant urologic diseases. The department has become one of the pioneers in the field of minimally invasive robot-assisted surgery (da Vinci), thanks to which it has exceptional experience in this area. In addition, the department became the second medical facility in Germany, which performed kidney transplantation using a da Vinci robotic system.

University Hospital Hamburg-Eppendorf

9.2/10
location_onGermany, Hamburg

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German medical facilities specializing in prostate cancer treatment! The department has all the diagnostic and therapeutic options to provide first-class medical care for patients with diseases of the genitourinary system. The priority focus is reconstructive urology, in particular, the whole range of urethral surgery, procedures for the treatment of urinary incontinence (including artificial sphincter implantation, sling procedures), as well as penile surgery for congenital or acquired malformations, prosthetics in case of erectile dysfunction.

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Adult and Pediatric Urology

The Department of Adult and Pediatric Urology offers the diagnostics and treatment of all diseases of the urinary system organs (kidneys, ureters, bladder, urethra, etc.), as well as of the male reproductive organs in adults and children. The department specializes in the surgical and drug treatment of oncological diseases, correction of complex malformations, and plastic reconstructive urology. The department is the certified Prostate Cancer Centre.

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Adult and Pediatric Urology

The Department of Adult and Pediatric Urology provides high-precision diagnostics and effective treatment of the full range of diseases of the kidneys, urinary tract, bladder, prostate, testicles and their appendages, vas deferens and penis. The treatment of urologic cancers is of particular interest. The focus of pediatric urologists is on young patients with congenital and acquired malformations of the genitourinary system. The department has its in-house advanced operating rooms, an X-ray unit, and two stations with 57 beds. The high quality of medical care is confirmed by many prestigious certificates, including the DEKRA certificate and the certificate of the European Board of Urology. As one of the best urologic facilities in Germany and a leading urology clinic in Munich, the department has been offering patients the daVinci robot-assisted surgery since 2009, which has many advantages for patients: minimal pain, speedy recovery, the highest level of precision compared to conventional surgical interventions.

University Hospital RWTH Aachen

8.7/10
location_onGermany, Aachen

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German medical facilities specializing in prostate cancer treatment! The department offers services for the diagnostics and treatment of diseases of the kidneys, urinary tract and pathologies of the reproductive organs in men. The therapeutic options are complemented by the treatment of urological problems in children. The department's doctors focus on the patients with oncopathologies (prostate cancer, renal cell cancer, bladder cancer, testicular cancer). Of particular interest is minimally invasive therapy of stones in the kidneys, ureters and bladder. The doctors have in their arsenal conventional and the very latest conservative, drug and surgical therapies, which allow them to achieve the best result in clinical cases of varying severity.

University Hospital Duesseldorf

9.5/10
location_onGermany, Duesseldorf

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German departments specializing in prostate cancer treatment! The department offers the widest range of modern diagnostic and therapeutic methods for accurate detection and treatment of diseases of the genitourinary system in men and boys. The priority focus of the department is the treatment of prostate cancer (certification of the German Cancer Society).

University Hospital Tuebingen

9.2/10
location_onGermany, Tuebingen

Department of Urology

According to the Focus magazine, the Department of Urology is included in the ranking of the top German departments for prostate cancer treatment! The department offers the full range of diagnostics and treatment of diseases of the kidneys, bladder and urinary tract, male genital organs. The department has advanced experience in urologic surgery and is one of the most reputable medical institutions specializing in the treatment of benign and malignant prostate diseases. In 2009, the department was certified by the German Cancer Society as the Prostate Cancer Center.

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the best German medical facilities for prostate cancer treatment! The department offers all diagnostic and therapeutic services in the field of its competence and specializes in the treatment of diseases of the genitourinary system in men of all age groups. The department has 46 beds for inpatient medical care. One of the key focuses is prostate cancer treatment (certification of the German Cancer Society as a Prostate Cancer Center). The doctors of the department are also highly professional in the treatment of diseases of the external genital organs in men, pathologies of the kidneys, adrenal glands, ureters, bladder and urethra in men and women.

Cryptorchidism is the most common developmental anomaly of the reproductive system in a boy. This is the malposition testis, in which the organ does not descend into the scrotum. The prevalence of the disease is 1-2% among the male population. Its complications are infertility, impotence, and malignant transformation of the undescended testicle. In the absence of one or two testicles in the scrotum, you can undergo your diagnostics and treatment in Germany. The level of medicine in this country allows one to expect the best results. On the Booking Health website, you can find the cost of treatment in Germany and choose the best medical care program.

Content

  1. When is it best to undergo diagnostics?
  2. When is cryptorchidism diagnosed?
  3. Diagnostics principles
  4. Instrumental diagnostics
  5. Laboratory diagnostics
  6. Where to undergo the diagnostics of the disease?

When is it best to undergo diagnostics?

 

The disease can be detected immediately after birth but sometimes the condition can be diagnosed later.

Over time, the testicle may descend into the scrotum on its own, so treatment is not always required. In newborns, an undescended testicle is detected with a probability of 20%, while the prevalence of the pathology among children over the age of 1 year is only 2%, and in adolescence it makes up 1%. The prevalence of the developmental anomaly in adult men is 0.2%.

But if there is no testicle in the scrotum, you should not delay visiting a specialist. The longer a patient goes untreated, the greater the loss of germ cells and the greater the risk of future fertility and hormone problems. In 80% of cases, the testicle descends into the scrotum in the first 3 months of life. If this has not happened before the age of 6 months, you should be diagnosed and treated. In older children, diagnostics and treatment are carried out immediately after the detection of a missing testicle in the scrotum.

When is cryptorchidism diagnosed?

 

Cryptorchidism is diagnosed when one or both testicles have not descended into the scrotum. The disease can develop in the following two ways:

  • retention;
  • ectopia.

Retention is a delay in the testicular descent. The condition can be inguinal and abdominal, depending on the stage at which the process of descending into the scrotum stopped.

Ectopia is the migration of the testis. Depending on where it is located, ectopia can be femoral, pubic, pubopenile, and perineal.

During the diagnostics, cryptorchidism is differentiated from a retractile testicle. It has descended into the scrotum, but its position is higher than usual due to elevation by the cremaster muscle. The difference becomes noticeable already on palpation. Unlike cryptorchidism, in the case of a retractile testicle, it can take the correct position if a doctor lowers it into the scrotum with his fingers during an examination.

Diagnostics principles

 

For men diagnostics of cryptorchidism includes the following:

  • symptom clarification;
  • clinical examination;
  • instrumental diagnostics.

Genetic tests are rarely required.

The presence of cryptorchidism can be recorded during a medical examination and palpation of the scrotum. Newborns and children in their first year of life are examined lying on their backs, and the rest are examined standing with their legs crossed. A doctor examines the groin, thigh, perineum, and pubis. The specialist pays attention to both halves of the scrotum. If the testicle is found in the inguinal canal, doctors try to advance it into the scrotum. If successful, the doctor may attempt to fix it. To do this, they press the hand on the spermatic cord to suppress the cremasteric reflex (the muscle that lifts the testicle). So the urologist can immediately distinguish cryptorchidism from a retractile testicle.

Instrumental diagnostics

 

In 70% of cases, palpation is sufficient to make a diagnosis. In the remaining 30% of cases, specialists resort to instrumental diagnostic methods.

The simplest, fastest, and most inexpensive diagnostic method is an ultrasound scan. Its diagnostic value, however, is not very high, so ultrasound scanning is rarely used in developed countries. Ultrasound examinations help to detect non-palpable testicles only in 45% of cases. In most men who fail to detect a testicle with ultrasound, it will eventually be detected in the abdominal cavity using other instrumental diagnostic methods.

Computed tomography is not used for cryptorchidism diagnostics. This is due to the fact that the method has a bad effect on the condition of the reproductive system.

An MRI scan is considered the main diagnostic method at hospitals in Germany to detect cryptorchidism. The technique allows the detection of an undescended testicle and clarifies its localization in most patients. The MRI scan cannot be used in all men with cryptorchidism. It is used only in cases when the unreduced testicle can not be palpated. In some cases, MRI scans can be performed after ultrasound if it was not possible to find the testicle using ultrasound diagnostics.

Laboratory diagnostics

 

Should gonadal dysgenesis be suspected, karyotyping will be performed. This technique involves determining the set of chromosomes in the patient's cells. Doctors can also detect mutations that lead to the underdevelopment of the reproductive system and low testosterone levels.

Below are some other tests that can be used for the diagnostic of cryptorchidism in Germany:

  • gonadotropin level testing in the blood (follicle-stimulating and luteinizing hormone);
  • anti-Mullerian hormone test;
  • testosterone level testing.

In the case of low testosterone levels, a test with human chorionic gonadotropin is performed. If the testicles are functioning properly, testosterone levels should rise.

Where to undergo the diagnostics of the disease?

 

You can seek medical attention from one of the hospitals in Germany to undergo your diagnostics and treatment. Diagnostics in this country are very accurate, and treatment in Germany is safe and effective. In a good hospital in Germany, the problem of cryptorchidism can be solved once and for all. The Booking Health staff will help you to select hospitals for treatment of this disease, reduce the cost of treatment, and arrange your trip.

Diagnostics at hospitals in Germany offers the following benefits:

  • comprehensive diagnostics, during which the fact of undescended testicle into the scrotum is confirmed, cryptorchidism is differentiated from other diseases and conditions, and the localization of the testicle is also determined;
  • high-quality medical imaging equipment that can detect undescended testicles in almost all patients;
  • doctors at hospitals in Germany do not use the methods with radiation exposure to visualize the reproductive system, since they have a bad effect on the reproductive function;
  • genetic diagnostics can be carried out to detect chromosomal abnormalities whenever required;
  • after your diagnostics at hospitals in Germany, you can undergo your treatment that will help to return the testicle to the correct position and maintain your reproductive function.

You are welcome to use the Booking Health website to find the cost of treatment in Germany and select a medical care program. The specialists from the Booking Health company will help you to find the most suitable hospitals in Germany. When choosing a medical care program through the Booking Health service, the cost of treatment in Germany will be lower due to the lack of additional fees for foreign patients.

 

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

 

Sources:

Verywell Health

Healthline

The Lancet

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