Cryptorchidism, more often referred to as undescended testicle, occurs when the testicle has not yet dropped into its position within the scrotum.
An undescended testicle is perhaps the most common of the genetic abnormalities that can occur in males. While the rate is quite low, at about 4% of births, the occurrence is much higher for boys that are born prematurely, with a rate of up to 30%. Typically, only one testicle is involved, though both testicles are involved in about 10% of these cases.
An undescended testicle will often resolve itself.
If it does not resolve itself, intervention is often required.
It is not clearly understood exactly what causes an undescended testicle, though genetics appear to play an important role. The condition occurs more frequently in boys who are born early or with low birth weight. Infants who have certain other medical conditions may also experience an undescended testicle. Maternal and environmental factors may also affect the proper development and movement of the testicles while the fetus is growing. If the mother smokes cigarettes or drinks alcohol during the pregnancy, this can disrupt the hormonal balance that is necessary for proper testicular formation. Exposure of the parents to certain pesticides prior to conception may also increase the risk of an infant being born with an undescended testicle.
This condition is mostly detected shortly after the baby is born, during the initial examination. The testicle will not be seen or felt within the scrotum. The physician will check to see if the testicle can be felt further up in the inguinal canal. If so, the physician may attempt to coax the testicle down into the scrotum. If this is not possible, it is likely that the boy is experiencing an undescended testicle. If the affected testicle readily moves down into the scrotum, this might be due to a retractile testicle. A retractile testicle can move freely and usually resolves by puberty.
If no testicle is found, surgery may be required to see if the testicle is still located within the abdomen, if it is damaged, or if it is missing completely. Left untreated, the patient may have trouble with fertility and may have a greater risk of developing testicular cancer. When the testicle is not in the proper place, it can become damaged through everyday activities.
Injections of human chorionic gonadotropin, also known as hCG, have been used in some cases, but the success rate is low. Surgery is generally recommended to release the testicle and attach it to the appropriate position within the scrotum. Surgery can be performed via laparoscopy through a small incision, or through general surgery. If surgery is required to locate the testicle, the relocation procedure can sometimes be performed at the same time. Some professionals recommend that undescended testicles that remain by 6 months of age should be corrected surgically, while others prefer to wait until the child is one year of age. Research has found that early intervention can reduce the risk of infertility and cancer, though it may not completely eliminate these risks.