What Is Cryptorchidism or Undescended Testicles?

Cryptorchidism can occur in one or both testicles and appears at birth. Most cases remit on their own in less than a year.
What Is Cryptorchidism or Undescended Testicles?

Last update: 20 December, 2020

Cryptorchidism, or undescended testicles, is a disorder characterized by the incomplete descent of one or both testicles through the inguinal canal into the scrotum. According to medical sources, the pathology is present when the testicle is permanently absent from the scrotal sac at six months of age or more.

Specialists estimate that the prevalence of this condition, that is, the number of patients in a given population, is 3 to 5% in newborn infants born at term. This value can increase by up to 30% in premature infants. If you want to know more about cryptorchidism and its characteristics, don’t miss this article!

What can cause the testicles not to descend properly?

As indicated by professional websites such as Mayo Clinic, the causes of cryptorchidism are still not entirely clear. The etiology of the disease can be due to both environmental factors (maternal and fetal conditions and exposure to chemicals) and genetic factors and syndromes with malformations.

Cryptorchidism is distributed as follows in infants throughout the world:

  • 3% to 5% of full-term children have cryptorchidism.
  • Up to 45% of premature infants enter the world with undescended testicles.
  • By three months of age, this figure drops to 1-2%.
  • Only 1% of children have cryptorchidism by one year of age.

In addition to all this data, we find it interesting that 10% of patients have both testicles undescended. In other words, most clinical cases are unilateral. Be that as it may, we are clearly dealing with a pathology linked to infants who are born before their due time.

A premature baby.
Prematurity is often associated with undescended testicles.

Who does cryptorchidism affect?

This pathology is related to the time and condition of birth. The risk groups prone to cryptorchidism are the following:

  • Children with low birth weight, that is, with less than 2500 grams of body mass
  • Premature birth
  • Family history of cryptorchidism or other testicular problems
  • Fetal conditions during pregnancy that may hinder development
  • Alcohol, tobacco, or exposure to certain chemicals by the mother during pregnancy

Symptoms and possible complications

The only obvious symptom is the absence of one or both testicles in the scrotum. In 80% of cases the non-visible testicles are palpable, while in the remaining 20% they are so retracted that they cannot be touched. Even so, it should be noted that most are transitory and the issue resolves itself after six months.

Unfortunately, as indicated by the U.S. National Library of Medicine, undescended testicles are more likely to develop cancer. In addition to this, an incorrect sperm temperature (due to proximity to the body) can translate into fertility problems.

What are the treatments for undescended testicles?

The aim of  interventions in patients with cryptorchidism is to descend the testicle that wasn’t able to descend naturally at the time. According to sources already cited, patients can take different paths to address the pathology. Among them we find the following:

  • Treatment with hormones: injecting B-HCG or testosterone can cause the descent of the infant’s testicle.
  • Testicular prosthesis and saline solutions: ideal for cases in which the patient completely loses one or both testicles.
  • Surgery: we’ll tell you more about this option below.

Surgical procedure and risks

Orchidopexy is the surgical procedure that doctors perform to lower the testicles into the scrotum. The surgeon will carefully bring the testicle into place and sew it up, thereby fixing it into place. According to Stanford Children’s Health, this operation has a 98% chance of success.

Possible risks include the following:

  • Injury to the spermatic vessels and testicular atrophy
  • Bleeding during surgery, post-op, or both
  • Appearance of an inguinal hernia
  • Bacterial infection due to the procedure
  • Opening of the wound during recovery that requires a second operation

Recovery

The patient must rest for 2 to 3 days after the operation and refrain from physical exercise for at least a month to protect the sutures. In addition, once the patient can remove the bandage, they must perform the hygienization process in the area of the surgical incision twice a day.

The patient must follow these rules in order to avoid unwanted infections. The stitches applied during sewing fall out on their own, so the patient doesn’t have to go to the doctor to have them removed.

Drinking alcohol during pregnancy.
Consuming toxins during pregnancy is another risk factor for cryptorchidism.

Cryptorchidism has a solution

Whether a child is born with one or both testicles undescended is usually not a cause for concern, as up to 99% of cases resolve themselves in less than a year. Even so, in patients whose testicles don’t descend naturally, hormonal treatment or surgery are safe and excellent options.

Cryptorchidism has a solution in almost all cases, whether they need to be operated on or not. Therefore, if you’re a parent and you see that your child has an undescended testicle, don’t worry! It’ll almost certainly not affect his lifestyle and he’ll be able to develop normally after receiving appropriate treatment.

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