CRYPTORCHIDISM

Introduction
Misplaced testes hidden in the abdomen at birth. Cryptorchidism (undescended testes) is a
congenital condition in which a baby boy is born with one or both of his testes not in the scrotum.
The testes normally drop down (descend) into the scrotum in the last 1 to 2 months before the
boy is born.
Many times the testes descend into the scrotum on their own by 2 years of age. If not, surgery
should be done to correct the problem. Testes that are not brought down into the scrotum
decrease a mans chances of producing a child, usually because e!cessi"e body heat damages
sperm production in the testes.
Types of undescended testis
1. Cannilicular testis
#ere the testicle located abo"e its natural position in the scrotum, body wall pre"ents
normal descent into the scrotum.
2. Intra-ado!inal testes
#ere the testicle is located inside the abdominal ca"ity residing in a position along its
pathway of natural descent. In such a position, it is not amenable to future e!amination by
a physician, $ it is at ris% of becoming cancerous.
". #ctopic testicle
#ere the testicle may be found in regions not in the usual pathway of descent into the
scrotum. &i"e ma'or sites of ectopia are perineum, femoral canal, super(cial inguinal
pouch, suprapubic area, $ contralateral scrotal pouch. The etiology is belie"ed to be
misdirected attachment to the scrotum
$. %sent testicle
)uch a phenomena of absent testicle can be bilateral (a*ecting both sides). It is belie"ed
to be associated with in utero torsion, "ascular insult, or agenesis.
Causes & ris' factors
The e!act cause of an undescended testicle isnt %nown (idiopathic).
+enetic, maternal health $ en"ironmental factors disrupts the hormone
,hysical changes $ ner"e acti"ity
-ow birth weight
,remature birth
&amily history of undescended testicle or other problems of genital de"elopment
Conditions that restrict growth of fetus . down syndrome/abdominal wall defect
0lcohol use by mother during pregnancy
Cigarette smo%ing by the mother
1besity in mother
2iabetes in mother
,arents e!posure to some pesticides
Clinical !anifestations
Testicles form in the abdomen during fetal de"elopment.
The testicles gradually lea"e the abdomen, pass through tube3li%e passageway in the groin
(inguinal canal) $ descend into the scrotum.
The testicles appear to be either missing or lopsided.
3 4on palpable testicle.
Dia(nostic e)aluation
5ltrasound
M6I
-aparoscopy
1pen surgery
Treat!ent
Treatment for Cryptorchidism includes both medical (hormonal) $ surgical approach separately
or in combination with one another. ,rocedures are usually completed between 7 $ 28 for
months of age for the best outcomes.
1. Medical treat!ent
3 Increasing the le"el of the male se! hormone testosterone can increase the li%elihood that
undescended testicles will mo"e into the scrotum. This is done by either gi"ing in'ections
of human chorionic gonadotropin (hC+) in doses of 9::: I.5. or gonadotropin releasing
analog.
2. Sur(ical treat!ent
3 Orc*idope+y
,lacement of testis in the scrotum should be accomplished by the age of 9yrs
3 Orc*idecto!y ,re!o)al of testis-
This surgery is done when the opposite testis is normal $ when incompletely
descended testis cannot be brought down.
3 Orc*idoceplioplasty
It in"ol"es the abdominal replacement of testis. It is indicated when the other testis has
been remo"ed pre"iously $ this testis cannot be brought down to the scrotum.
.ursin( dia(nosis
1. )e!ual dysfunction related to absence of a testicle
2. 0n!iety related to surgery
;. <nowledge de(cit related to disease condition
8. 6is% of cancer de"elopment related to abnormal hormonal production.