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Medical condition
Cryptorchidism
Cryptorchidism on scrotal ultrasound
Specialty
Medical genetics
Cryptorchidism, also known as undescended testis, is the failure of one or both testes to descend into the scrotum. The word is from Greek κρυπτός (kryptos) 'hidden' and ὄρχις (orchis) 'testicle'. It is the most common birth defect of the male genital tract.[1] About 3% of full-term and 30% of premature infant boys are born with at least one undescended testis.[2]
However, about 80% of cryptorchid testes descend by the first year of life (the majority within three months), making the true incidence of cryptorchidism around 1% overall. Cryptorchidism may develop after infancy, sometimes as late as young adulthood, but that is exceptional.
Different forms of cryptorchidism, depending on the position of the undescended testicle. Sometimes the retractile testicle is added.
Cryptorchidism is distinct from monorchism, the condition of having only one testicle. Though the condition may occur on one or both sides, it more commonly affects the right testis.[3]
A testis absent from the normal scrotal position may be:
Anywhere along the "path of descent" from high in the posterior (retroperitoneal) abdomen, just below the kidney, to the inguinal ring
In the inguinal canal
Ectopic, having "wandered" from the path of descent, 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)
Missing (also see anorchia).
About two-thirds of cases without other abnormalities are unilateral; most of the other third involve both testes. In 90% of cases, an undescended testis can be felt in the inguinal canal. In a small minority of cases, missing testes may be found in the abdomen or appear to be nonexistent (truly "hidden").
Undescended testes are associated with reduced fertility, increased risk of testicular germ-cell tumors, and psychological problems when fully-grown. Undescended testes are also more susceptible to testicular torsion (and subsequent infarction) and inguinal hernias.[citation needed] Without intervention, an undescended testicle will usually descend during the first year of life, but to reduce these risks, undescended testes can be brought into the scrotum in infancy by a surgical procedure called an orchiopexy.[4]
Although cryptorchidism nearly always refers to congenital absence or maldescent, a testis observed in the scrotum in early infancy can occasionally "reascend" (move back up) into the inguinal canal. A testis that can readily move or be moved between the scrotum and canal is referred to as retractile.
Cryptorchidism, hypospadias, testicular cancer, and poor semen quality make up the syndrome known as testicular dysgenesis syndrome.
^Wood, HM; Elder, JS (February 2009). "Cryptorchidism and testicular cancer: separating fact from fiction". The Journal of Urology. 181 (2): 452–61. doi:10.1016/j.juro.2008.10.074. PMID 19084853.
^"Cryptorchidism". Lecturio. Retrieved 11 July 2021.
^Tamparo, Carol (2011). Diseases of the Human Body (Fifth ed.). Philadelphia, PA. pp. 125. ISBN 978-0-8036-2505-1.{{cite book}}: CS1 maint: location missing publisher (link)
^"Undescended testicle". A.D.A.M. Medical Encyclopedia. Johns Creek, Georgia, USA: Ebix. 31 July 2019. Retrieved 9 February 2022.
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