Cryptorchidism: Causes, Symptoms, and Treatment Options

During fetal life the testicles have to make a long journey from the inside of the abdomen to the scrotum. The descent of the testicles occurs in the. Sometimes the testicles stay halfway and cannot be felt in the scrotal bag and this is what we call cryptorchidism.

The testicles that have not descended at one year of life they must be carefully evaluated.

Causes

• Total absence of testicle (anorchia): it may be due to a hormonal problem or because it was twisted during fetal life that made it disappear. Over time (beginning in adolescence) these children are fitted with a prosthesis inside the scrotum for psychological reasons.
• The testicle does not descend into the scrotal bag because it is in the abdomen. It is a situation that must be resolved in the first two years of life, usually with surgery. If the testicle is not lowered to its normal position there is a risk of having a sterility problem in adult life since it may lose its function: to manufacture sperm.
• Ectopic testicles.
• The testicle is sometimes in the scrotal bag and sometimes it is not: retractile testicle or by elevator.

Diagnosis

Diagnosis is made by physical exploration not being the testicles or the testicle in the scrotal bags. It should not be confused with elevator tests, in which the test has an upward retractable movement, spending most of the time in the scrotum. The or the testis can be found intra-abdominal, in the inguinal canal, or outside its normal place of development. Must be correct their position before the age of two. In most children before the first year of life it has already decreased.

Treatment

The cryptorchid should be corrected to ensure proper gonadal function in the future. An inguinoscrotal ultrasound may be performed to try to locate the testes in the inguinal canal. MRI is useful for locating the testicles, but in young children it requires sedation, so it is better to perform an examination directly. exploratory laparoscopy and trying to lower the testicle in the same surgical act. If the test is located in the inguinal canal, an incision similar to that of an inguinal hernia is made, and through it the entire testicle is released until it is brought into the scrotum. Finally it is fixed to the scrotum so that it does not rise again.

Can be done hormonal treatment with HCG or analogues of the pituitary hormones to try to descend the testicle.