Definition of "Undescended testicle"

Last modified: 25 days



Undescended testicle (aka cryptorchidism, from Greek "crypto" meaning "hidden", and "orchis" meaning "testicle" is the congenital absence of testes (one or both) from the scrotum.

Note that a testis in early infancy can occasionally "reascend" into the inguinal canal. A testis which can readily move between the scrotum and canal is referred to as retractile.

Pathophysiology

A testis absent from the normal scrotal position can be found:

  • Along the path of descent from the high in the posterior (retroperitoneal) abdomen, just below the kidney, to the inguinal ring
  • In the inguinal canal
  • Ectopically, i.e. to have wandered from its path, usually outside the inguinal canal and sometimes even under the skin of the thigh, the perineum, the opposite scrotum, or the femoral canal
  • Undeveloped (hypoplastic) or severely abnormal (dysgenetic)
  • To have vanished (anorchia)
DDx
  • Monorchism, the condition of having only 1 testicle
Tx
  • Usually self limiting
  • To reduce risk, undescended testes can be brought into scrotum in infancy using surgery, known as orchiopexy
Complications

Associated with:

  • Reduced fertility
  • Increased risk of testicular germ cell tumors
  • Psychological problems when the boy is grown

Increased risk of:

  • Testicular torsion (and subsequent infarction)
  • Inguinal hernias
Prognosis
  • 80% of undescended testes descend by the 1st year of life, with the majority within 3 months, making the true incidence of non-self limiting undescended testes 1%
Epidemiology
  • Most common birth defect of the male genetalia
  • Can develop later in life, often as late as young adulthood
  • 3% of full term, and 30% of premature infants are born with at least 1 undescended testis
  • 66% of cases are unilateral, 33% involve both testes
  • In 90% of cases, the undescended testis can be felt in the inguinal canal; only a minority are in the abdomen or nonexistent (truly hidden)

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Definition of Undescended testicle | Autoprac


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