J Korean Med Assoc.  2008 Jul;51(7):643-650. 10.5124/jkma.2008.51.7.643.

Diagnosis and Management of Cryptorchidism

• Ryu DS

• KMID: 2185915
• DOI: http://doi.org/10.5124/jkma.2008.51.7.643

Abstract

Cryptorchidism or an undescended testis is one of the most common congenital anomalies found at birth and affects about 3% of full-term male newborns. A cryptorchid testis can be located anywhere between the abdominal cavity and just outside the scrotum, and 80% of undescended testes are palpable. Approximately three-fourths of cryptorchid testes will spontaneously descend, usually by 3 months of age. Children with retractile testes require annual follow-up until puberty or the testis is no longer retractile. Determination of whether the testis is present on physical examination is critically important because it guides further workup and treatment. Although radiological evaluation does not have a relevant role in the assessment of undescended testes and would not influence surgical management, many physicians have been performed it to verify the location and condition of cryptorchid testis. The efficacy of hormonal treatment is less than 20% and is significantly dependent on pretreatment testicular location. Therefore, surgical repositioning of the testis within the scrotal sac, i.e., orchiopexy, remains the gold standard for the management of undescended testes and it should be performed between 6 and 12 months of age because spontaneous descent occurs uncommonly thereafter, and in order to prevent the complications and long-term sequelae of cryptorchidism, such as testicular torsion, trauma, infertility, and testicular cancer. Recently, laparoscopy has attained its greatest degree of general acceptance, both diagnostically and therapeutically, in the realm of pediatric urology for the management of a nonpalpable testis.

Keyword

Cryptorchidism; Undescended testis; Orchiopexy; Laparoscopy

MeSH Terms

Abdominal Cavity
Child
Cryptorchidism
Follow-Up Studies
Humans
Infant, Newborn
Infertility
Laparoscopy
Male
Orchiopexy
Parturition
Physical Examination
Puberty
Scrotum
Spermatic Cord Torsion
Testicular Neoplasms
Testis
Urology

Figure

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  Figure 1 Distribution of the recommended age of orchiopexy in patient with unilateral palpable cryptorchidism according to the urologists in Korea (unpublished data).

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  Figure 2 Management of a non-palpable testis (Schneck FX, Bellinger MF. Campbell-Walsh Urology 2007).

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