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.
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It is more difficult to determine the etiology of testicular atrophy in undescended testes in men than in laboratory animals subjected to experimental cryptorchidism because laboratory animals have normal testes before the experiment, whereas in humans with congenital cryptorchidism, it is possible that the testes had lesions other than cryptorchidism itself, possibly congenital lesions, and that the severity of these lesions varies widely.
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Some researchers suspect an increasing incidence of hypospadias, low sperm production, and undescended testes in men may trace to estrogen-mimicking pollutants (SN: 1/22/94, p.
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Although bilateral undescended testes, micropenis and cardiac anomalies were present in our case, none of the abovementioned findings which are included in these syndromes was present and the clinical findings were not compatible with any other syndrome described so far.
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A 2-year-old boy was admitted to our clinic with duplicated urethra, urethral stenosis, bilateral undescended testes, neurogenic bladder dysfunction, vesicoureteral reflux, renal agenesis, cross ectopy of the right kidney, thoracic kyphoscoliosis and recurrent urinary tract infections.
A case report: Bir erkek cocuktaki uretra dubfikasyonu ve olasi MURCS (mullerian-renal-seryikal-spinal) sendorumu / Duplicated urethra and a possible mullerian-renal-cervical spine (MURCS) association in a male child
16] Patients with bilateral undescended testes have significantly lower sperm motility, sperm concentration, testicular volume and inhibin B levels, while showing higher FSH and LH levels than those with unilateral undescended testis.
Cryptorchidism and its impact on male fertility: a state of art review of current literature
Indeed, they note, the "most consistent occupational association has been with employment in professional or white,collar occupations" and the major risk factor, undescended testes at birth.
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Social and medical aspects of undescended testes in Turkey.
The testicles and penis sizes and rates of external genital organ anomalies in primary school boys in Samsun/Samsun ilinde ilkogretim cagi erkek cocuklarda testis ve penis boyutlari ve dis genital organ anomali oranlari
The only sign that they could develop cancer is undescended testes in childhood which is strongly associated with the gene on chromosome Xq27.
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Because the failure of these ducts to regress has been associated with undescended testes, abnormalities in MIS production may play a role in cryptorchidism.
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The prevalence, postnatal descent, and complications of undescended testes among children who underwent neonatal circumcision in Benin City, Nigeria.
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The higher prevalence of congenital abnormalities related to testicular descent observed in the study group should not be overlooked simply because it failed to achieve statistical significance (which may be due to small sample size), because there is indirect evidence of endosulfan exposure associated with undescended testes in a human population from Spain.
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But the most significant risk factor is undescended testes - when the testes have not dropped from where they developed in the abdomen as a youngster.
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