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Published on: March 31, 2023
Management of cryptorchidism.
1Department of Pediatrics, Division of Pediatric Endocrinology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467, USA.
Trends in Endocrinology and Metabolism: TEM
|September 1, 1992
Summary
Testicular descent is guided by hormones like testosterone, and malfunction often precedes cryptorchidism (undescended testes). Early surgery maximizes fertility in bilateral cases, and lifelong monitoring is crucial due to increased cancer risk.
Area of Science:
- Reproductive Endocrinology
- Pediatric Surgery
- Urologic Oncology
Background:
- The precise mechanisms governing testicular descent remain incompletely understood.
- Hormonal influences, including testosterone and anti-Müllerian hormone, are implicated.
- Testicular malfunction frequently precedes cryptorchidism, a condition characterized by undescended testes.
Purpose of the Study:
- To review the current understanding of testicular descent.
- To discuss the management controversies surrounding cryptorchidism.
- To highlight the long-term implications of cryptorchidism, including fertility and cancer risk.
Main Methods:
- Literature review of hormonal roles in testicular descent.
- Analysis of management strategies for unilateral and bilateral cryptorchidism.
- Examination of the association between cryptorchidism and testicular cancer.
Main Results:
- Testosterone and anti-Müllerian hormone are potential regulators of testicular descent.
- Surgical intervention by age one is recommended for bilateral cryptorchidism to optimize fertility.
- Gonadotropin-releasing hormone (GnRH) is not considered effective for initiating descent.
Conclusions:
- Cryptorchidism significantly increases the risk of testicular cancer (3-10 fold).
- Even in unilateral cases, tumors can occur in normally descended testes.
- Lifelong medical surveillance and testicular self-examination are essential for individuals with a history of cryptorchidism.
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