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 ?
INSL3 and AMH in patients with previously congenital or acquired undescended testes. Journal of Pediatric Surgery, 52, 1327-1331.
We used diagnostic and operative laparoscopy in the management of 52 patients with 61 undescended testes. 26 patients had 28 palpable testes (45%), and 26 patients had 33 nonpalpable testes (55%).
Undescended testes comprised 14% (12 cases) of the total testicular biopsies received; however, none of these cases showed malignancy.
Lap aroscopic versus open orchiopexy for non-palpable undescended testes in children: a systemic review and meta-analysis.
The clinical and laboratory course of an 11-year-old boy diagnosed with 17-[beta]-HSD3 deficiency at the age of six-weeks old following his presentation with ambiguous genitalia (stretched penile and bilateral undescended testes) is described.
Studies have also linked the chemicals - found in thousands of plastic products - to problems with sexual development, reduced fertility levels and undescended testes.
There was no history of trauma, hernia, or undescended testes. On physical examination, two palpable, ovoid, mobile, non-tender masses with testicular sensation were detected in the left hemiscrotum.
Sinha CK, Vinay S, Kulkarni R, Nour S (2008) Delayed diagnosis for undescended testes. Indian Paediatrics 45: 503-4.
Objective: To compare the efficacy and complications of single incision trans scrotal versus standard inguinal orchidopexy in children with palpable undescended testes.
According to scientists, the worldwide fall in sperm counts has been accompanied by a rise in testicular cancer - rates have doubled in the last 30 years - and in other male sexual disorders such as undescended testes, which are indicative of a "worrying pattern."
(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.