Undescended Testes


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Undescended Testes

 

Definition

Also known as cryptorchidism, undescended testes is a congenital condition characterized by testicles that do not extend to the scrotum.

Description

In the fetus, the testes are in the abdomen. As development progresses they migrate downward through the groin and into the scrotum. This event takes place late in fetal development, during the eighth month of gestation. Thirty percent of premature boys have testes that have not yet made the full descent. Only 3-4% of full-term baby boys have undescended testes, and half of those complete the journey by the age of three months. Eighty percent of all undescended testes cases naturally correct themselves during the first year of life. Undescended testes that are not corrected can lead to sterility and an increased risk of testicular cancer.

Causes and symptoms

The cause of undescended testes is presently unknown, however its symptoms are quite apparent. One or all of the testicles can be undescended, therefore the testicles appear to be either missing or lopsided.

Diagnosis

The newborn examination always checks for testes in the scrotum. It they are not found, a search will be conducted, but not necessarily right away. In most cases, the testes will drop into place later. If the testes are present at all, they can be anywhere within a couple inches of the appropriate spot. In 5% of cases, one testis is completely absent. In 10%, the condition occurs on both sides. Presence of undescended testes is indicated by measuring the amount of gonadotropin hormone in the blood.

Key terms

Cryptorchidism — Undescended testes.
Embryonic — Early stages of life in the womb.
Fetal — Refers to the fetus, also known in the first two months after conception as an embryo.
Orchiopexy — Surgical procedure that places the testicles in the scrotum.

Treatment

Once it is determined that the testes will not naturally descend, surgery becomes necessary. The procedure is called an orchiopexy and is relatively simple once the testes are located. The surgery is usually performed when the boy is between one to two years old.

Prognosis

Undescended testes must be treated to eliminate the increased risk of testicular cancer and the possibility of sterility. Undescended testes are twice as likely to develop cancer. Ten percent of all testicular cancers are in undescended testes.

Resources

Books

Rajfer, Jacob. "Congenital Anomalies of the Testes and Scrotum." In Campbell's Urology, edited by Patrick C. Walsh, et al. Philadelphia: W. B. Saunders Co.,1998.
References in periodicals archive ?
However, unlike in the Western population, malignancy developing in the undescended testes was rare.
Scrotal incision orchidopexy for undescended testes with or without a patent processus vaginalis.
Testicular neoplasia in undescended testes of cryptorchid boys-does surgical strategy have an impact on the risk of invasive testicular neoplasia?
Lap aroscopic versus open orchiopexy for non-palpable undescended testes in children: a systemic review and meta-analysis.
21) As in our case, male newborns with 17-[beta]-HSD3 deficiency usually have external genitalia with feminizing features together with undescended testes usually in the inguinal region or in a bifid scrotum.
Other non-urgent surgical conditions Aetiology Aetiology Hydrocele Caused by a patent * Seen either in (Smith and Kenny processus vaginalis neonates or early 2008, Tiemstra and allowing fluid to infancy Kapoor 2008) collect around the testes * Non-tender fluid filled scrotal swelling * Transilluminates when a torch is shone under the scrotum Undescended testes Incidence 33% in Picked up during (Sinha et al, 2008; pre-terms, 3-5% in routine baby checks: Docimo et al, 2000) full term neonates unable to palpate and 0.
Children aged 9 months to 12 years, diagnosed as cases of palpable undescended testes were randomized into two groups.
2) Most bilateral testicular tumours in undescended testes present as metachronous lesions, and synchronous bilateral tumours in bilateral cryptorchidism have not been reported.
Undescended testes are divided into two categories: those that the physician can feel on examination (palpable) and those that cannot be felt on examination (nonpalpable) More than 75% of undescended testes are palpable.
Undescended testes carry a higher potential for malignant transformation than normally descended testis.
Women who take over-the-counter painkillers during pregnancy have an increased risk of having sons born with undescended testes, according to a study that also incorporates rat models to show why this might be.
undescended testes, congenital inguinal hernia, or testicular injury) may change the estrogen-level balance.