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Cryptorchidism (Undescended Testicle)
Van Nguyen1, Larry Ngo1, Ecler Ercole Jaqua1
1Loma Linda University Health, Loma Linda, California.
Insights
Cryptorchidism, or undescended testicles, is common in male infants. Early surgery and lifelong monitoring are crucial for preserving fertility and reducing testicular cancer risk.
Area of Science:
- Pediatric Urology
- Genitourinary Malformations
Background:
- Cryptorchidism is the most common genitourinary malformation in male children.
- Early identification by primary care physicians is essential.
- Undescended testicles carry risks of infertility and testicular cancer.
Purpose of the Study:
- To outline the diagnosis and management of cryptorchidism.
- To emphasize the importance of timely surgical intervention.
- To detail post-operative surveillance and counseling needs.
Main Methods:
- Diagnosis relies on patient history and physical examination.
- Surgical intervention is recommended by six months of age.
- Endocrinologic evaluation is indicated for nonpalpable bilateral undescended testicles.
Main Results:
- Early surgery significantly reduces risks associated with cryptorchidism.
- Lifelong surveillance is necessary for fertility and cancer risk management.
- Retractile testicles require annual monitoring until puberty.
Conclusions:
- Prompt surgical correction of cryptorchidism is vital.
- Comprehensive lifelong care, including self-examination, improves outcomes.
- Management strategies should be tailored to individual patient needs.
Abstract:
Cryptorchidism refers to an undescended testicle, the most common genitourinary malformation in male children. It is diagnosed with history and physical examination findings, and primary care physicians play a key role in the early identification of the condition. Early surgical intervention reduces the risk of testicular cancer and preserves fertility. Patients should be referred for surgical intervention at six months of age or at the time of diagnosis if the child is older. After surgery, patients require lifelong surveillance and counseling regarding fertility implications and increased risk of testicular conditions. Patients with bilateral undescended testicles that are nonpalpable should undergo endocrinologic evaluation for sexual development disorders. Retractile testicles are a variant of cryptorchidism and should be monitored annually until puberty, when acquired ascent becomes unlikely due to greater testicular volume. Based on expert opinion, all patients with a history of cryptorchidism should undergo annual clinical examination and be taught self-examination techniques for early detection of testicular cancer.
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