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The relationship between cerebral palsy and cryptorchidism
J A Smith1, J M Hutson, S W Beasley
1Department of General Paediatrics, Royal Children's Hospital, Melbourne, Australia.
Journal of Pediatric Surgery
|December 1, 1989
Summary
This study suggests that the position of testes in boys with cerebral palsy does not change with age, unlike in typically developing children. This finding questions early hypothalamic-pituitary-gonadal axis damage theories and points to cremaster muscle spasticity as a cause of cryptorchidism in cerebral palsy.
Area of Science:
- Pediatric Neurology
- Urology
- Developmental Biology
Background:
- Cryptorchidism, or undescended testes, is frequently reported in children with cerebral palsy.
- Previous theories suggested early damage to the hypothalamic-pituitary-gonadal axis causes testicular maldescent in cerebral palsy.
Purpose of the Study:
- To investigate the association between cerebral palsy and cryptorchidism.
- To examine testicular position changes with age in boys with cerebral palsy compared to controls.
- To evaluate the validity of existing theories on the etiology of cryptorchidism in cerebral palsy.
Main Methods:
- Comparative study involving 50 boys with cerebral palsy (divided into two age groups: <2.5 years and 5-10 years) and age-matched controls.
- Assessment of testicular position relative to age in all study groups.
Main Results:
- Testes position remained static with age in boys with cerebral palsy.
- In typically developing children, testes descended slightly with age (P < .005 initially, P < .001 with further growth).
Conclusions:
- The findings challenge theories implicating early hypothalamic-pituitary-gonadal axis damage in cerebral palsy-associated cryptorchidism.
- Spasticity of the cremaster muscle is postulated as a potential cause for apparent increased cryptorchidism in older boys with cerebral palsy, leading to testicular retraction.