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Ferment, a sign of progress in any scientific field, has previously been lacking in the area of cryptorchidism, where the only activity has been in improving operative methods. Now, however, profound changes in the care of boys with cryptorchidism are being brought about; ideas are arising from a fresh look at comparative anatomy, and histological and experimental observa tions are being supplemented by clinical tests made possible by new hormonal agents. The treatment of cryptorchidism begins with its recognition by the pediatri cian, who until now has shown little interest because of disappointing results from chorionic gonadotropin administration. As for the surgeon, his bent toward restoration of normal anatomical relationships has kept his attention focused on the development of better surgical technics to bring the recalci trant testis into the scrotum. Both specialists have avoided the primordial question of why the testis did not descend properly. If this were known they would treat the cause of cryptorchidism, and not be satisfied merely with trying to correct its end result. As one reads this book, one sees that in most patients cryptorchidism is not caused by some anatomical structure blocking the way or by some deformity of the testis interfering with the transport mechanism. Rather, deficiencies in the hormonal environment of the fetus retard the developmen tal sequences essential to the normal differentiation and descent of the testis. The clinical solution is thus to provide the deficient substances."
The subject matter in this volume was derived from papers presented at the Pediatric Andrology session of the 1st Pan American Congress of Andrology held in Caracas, Venezuela in February 1979, as well as from selected additional manuscripts of interest in this field. Prior to this session, identification of a distinct discipline and specialty devoted to pediatric andrology had not occurred, nor had it been conceptualized. Pediatric andrology encompasses many different areas: disorders of sexual development, structural disease of the genital organs, normal and abnormal puberty, undescended testes, genital tumors, gonadal function and its relationship to growth, virilization, fertility and gender identity all represent areas of specific interest, to name but a few. Andrology itself is a unique field, bringing together clinicians and basic scientists with diverse back grounds. It should be noted that between one-half and three-quarters of the clinicians contributing to this issue conduct basic research as well. It has been this unique blend of basic research and clinical medicine which has done much to unravel many of these problems characteristic of this field."
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