Cryptorchidism – Undescended testicle in children
Cryptorchidism is a retained testicle, which is absent unilaterally or bilaterally in the scrotum.
Causes of Cryptorchidism
- Wrongly directed descent of the testicle during embryonic development. Particularly relevant to a gonadotropic hormone secreted by the anterior part of pituitary.
Undescended testicle in children - video explanation
Types of Cryptorchidism
• Abdominal testicle– retained testicle is located in the abdominal cavity, most – often immediately behind the internal iliac orifice (retentio abdominalis).
• Inguinal testicle – retained testicle can be palpated in the inguinal ligament (retentio inguinalis).
• Slipping testicle – retained testicle is pushed into the scrotum, but it can’t be hold there because of a very short funiculus.
• “Wandering” testicle – the testicle is pressed hard into the scrotum. Going back is possible not because of a too short funiculus, but because of the cremasteric reflex.
If after the first year of life there is retention of the testicles, it must be regarded as a disease, which requires treatment!
Treatment of Cryptorchidism
The second year of life is a reminder for a coming operation, which is better to be done in the first half of the third year. In cases of parallel existing inguinal hernia, a considerably earlier operation is needed. The final correction of Cryptorchidism must be completed during the third year of life! A hormone therapy can be tried or 5 weeks in the first and the second year. Children at the age of 2-6 can also undergo such hormone treatment. If the first course of treatment is unsuccessful, an operation should be performed.
Conservative or surgical treatment of retained testicle must begin before starting school!
The best chance for success in high located testicle should be expected with retractile testicle. The worst results can be seen with unilateral Cryptorchidism or inguinal testicle
Children, who after the age of 10, have carried out an operation (Orchidopexy), should undergo a yearly examination because of an increased risk of testicular cancer!
Complications of Cryptorchidism
- Disturbance in the endocrine or spermatogenic function, infertility, malignant delivery with a development of cancer of the testicles.
Diseases, which might be confused with Cryptorchidism:
- Congenital absence of a testicle (anorchia), ectopia of the testicle.