The male offspring of women who took diethylstilbestrol during pregnancy have an increased incidence of genital abnormalities and a possibly increased risk of prostate and testicular cancer. Routine prostate cancer screening and testicular self-examination should be encouraged.
The sons of women who took DES during pregnancy are three times more likely to have genital structural abnormalities than men without such exposure. The most common abnormalities are epididymal cysts, undescended testes, and small testes. Epididymal cysts have no clinical implications, but undescended testes and small testes are associated with an increased risk of testicular cancer. Men with in utero DES exposure also have sperm and semen abnormalities but do not have a(n) (much) increased risk of infertility or sexual dysfunction.
There is some concern about the effects of DES on the prostate. One study that examined the prostatic utricle of male stillborns who were exposed to DES in utero showed a significantly higher incidence of squamous metaplasia in this müllerian-derived tissue.
A recent study showed a possibly increased incidence of testicular cancer in men with in utero DES exposure. Although this finding was not statistically significant, the investigators concluded that the connection between DES and testicular cancer “remains uncertain,” and suggested that ongoing clinical surveillance would be prudent. Therefore, the sons of women who took DES during pregnancy should be encouraged to practice routine testicular self-examination.
- Diethylstilbestrol exposure, American family physician, afp/2004/0515/p2395, 2004.
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