Testes, Undescended

(Cryptorchidism)

 

Definition

A disorder present at birth in which one or both testicles have not descended from the pelvis into their normal position in the scrotum. 3% of full-term newborn males and 30% of premature newborn males have undescended testes. Most descend spontaneously without treatment by 1 year of age.

Signs and Symptoms

  • Scrotum appears undeveloped on one or both sides.
  • Testicle can’t be felt in its normal position in the scrotum.

Causes

  • Unknown, but probably related to hormone deficiency in the mother or fetus.
  • Presence of fibers that interrupt its route and cause it to remain in the groin.

Treatment

  • Diagnostic tests may include ultrasound or CT scan if testis cannot be felt.
  • Treatment will be determined by type of cryptorchidism. If the testis lies in the scrotum at times and then retracts occasionally, the problem normally resolves itself by puberty. Other forms are treated with hormones or by surgery.
  • Surgery to move the testes into the scrotum. Surgery is the only treatment for those who don’t respond to hormone treatment. Surgery ideally should be performed at 21 to 15 months, but no later than puberty to preserve reproductive function.

Medications

May prescribe human chorionic gonadotropins (HCG’s) by injection. These are usually given 3 times a week for 4 to 6 weeks. This treatment causes testes to descend normally in about 25% of cases.

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