Cryptorchidism - definition and treatment

Undescended testicle. The TESTICLES form within the abdominal cavity early in fetal development and normally descend through the inguinal canal at the floor of the pelvis into the SCROTUM during the third trimester of PREGNANCY. In some boys the testicle may spontaneously descend during the first year of life; after one year of age, however, this is unlikely. Numerous factors contribute to cryptorchidism, key among them being genetic and hormonal influences.

Treatment to bring the testicle outside the body is essential to preserve FERTILITY and because a testicle retained within the abdominal cavity has a high risk for TESTICULAR CANCER.

Treatment options are hormonal therapy, in which GONADOTROPIN-RELEASING HORMONE (GNRH) administration may stimulate the testicle to descend on its own, and surgery (ORCHIOPEXY) to shift the testicle from its abdominal position into the scrotum. Orchiopexy is the more common therapeutic route. Surgery sometimes involves procedures to repair related structures such as the arteries and veins that supply the testicle and the VAS DEFERENS, the tubular structure that transports SPERM from the testicle. Bilateral cryptorchism, in which both testicles are undescended, often results in sterility (permanent inability to father a child) because normal body temperature destroys the ability of the testicle to produce sperm.

Even after treatment the risk for testicular cancer remains higher than normal; boys and men who have had cryptorchidism should perform monthly TESTICULAR SELF-EXAMINATION. Most men who had successful treatment for cryptorchidism early in childhood have full fertility. Cryptorchidism does not affect sexual function.

See also FERTILITY; HYPOGONADISM; HYPOSPADIAS; SURGERY BENEFIT AND RISK ASSESSMENT.

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