Cryptorchidism: Types, Causes, Signs and Treatments
What Is Cryptorchidism?
Cryptorchidism literally means hidden or obscure testis. The word is derived from two Greek words, "crypto" (hidden) and "orchid" (testis). During pregnancy, the testes develop in the abdomen. They should descend into the scrotum by the end of the 36th week of gestation.
Testicles Are Located Inside the Scrotum
The scrotum is a small sac of skin that hangs behind the penis. Inside the scrotum is a pair of testicles, the oval-shaped sex organs that are part of the male reproductive system. The testicles produce sperm and testosterone, a hormone that plays a key role in male sexual development.
In some infants, the undescended testis descends into the scrotum before it is six months of age. If it does not happen, then the infant may be affected by this medical disorder.
Cryptorchidism Is Also Known As Undescended Testicle
Also known as undescended testicle (UDT), cryptorchidism is a congenital disorder in which either one testis or both the testes of the affected infant remain in the abdomen, in the inguinal canal, or at the external ring, instead of descending into the scrotum.
Cryptorchidism Usually Affects the Right Testis
This medical condition usually affects the right testis. Cryptorchidism increases the risk of hernia, infertility, testicular cancer and testicular torsion. It may also cause significant psychological impact as the child grows.
It is estimated that around 4 percent of full-term boys and 21 percent of male infants born preterm are born with this condition. Usually, only one testicle is affected, but in 10 percent of all cases, both testicles are affected.
Cryptorchidism is the most common genital condition that is identified at birth. It is more likely to affect boys who are born prematurely.
Types of Cryptorchidism
Three main types of cryptorchidism are:
- Atrophic or absent
Causes of Cryptorchidism
Cryptorchidism cannot be prevented. Prematurity is the main cause of this medical condition. Cryptorchidism may also occur due to hormonal disorders.
Spina bifida is a birth defect that involves incomplete development of the spinal cord or its coverings. This medical condition is known to cause cryptorchidism. CRKL in 22q11.2 is a key gene that contributes to common birth defects like cryptorchidism.
Unhealthy maternal lifestyle during pregnancy, like smoking, high prepregnancy BMI, alcohol consumption and excessive caffeine intake may constitute possible risk factors for cryptorchidism.
Signs of Cryptorchidism
In the person affected by this medical condition, either one testis or both the testes will be absent. UDT may be palpable or unpalpable. A palpable, UDT can be felt during a physical examination.
The testicle is usually located at the end of the inguinal canal, a channel that carries the spermatic cord towards the penis and scrotum in males.
About 80 percent of cases UDT is palpable. The affected person may also suffer from pain in the groin area. Adults affected by this medical condition usually suffer from infertility.
Did you know about cryptorchidism before reading this article?
Treatment for Cryptorchidism
Whether it affects one or both testicles, this condition usually corrects itself within a few months, but sometimes surgery is required to relocate the testicle, or testis, into the scrotum.
Cryptorchidism can be completely cured if it is diagnosed and treated before the child is two years of age. It is usually treated when the child is between 6 months and 2 years of age.
Doctors usually feel the testicle above the scrotum. If it is not found by physical examination, then they use a procedure called diagnostic laparoscopy. This helps them to locate the exact position of the testis. This procedure involves insertion of a miniature video camera into the body.
Doctors use orchiopexy to treat this medical condition. This surgical procedure is performed in order to move the undescended testis into the scrotum. In this procedure, the testicle is fastened with absorbable sutures. Orchiopexy is performed before the child reaches four years of age and may reduce the risk of infertility.
After this treatment, 50 to 65 percent of males with two undescended testes and 85 percent with a single undescended testis have regained fertility. In some cases doctors use human chorionic gonadotropin (administered intramuscularly) to stimulate descent of the testis.
Also known as hCG, this glycoprotein hormone is composed of 244 amino acids. Hormone injections are widely used as a treatment to this medical disorder in Europe, but they are not used much in the US. Doctors usually recommend testicular prostheses to deal with either absence of testis or abnormal testis.
Early diagnosis and management of the undescended testicle (Cryptorchidism) are needed to preserve fertility and prevent other complications such as testicular neoplasm, testicular torsion and inguinal hernia.— Dr Wale Okediran
- Cryptorchidism literally means hidden or obscure testis
- Cryptorchidism increases the risk of diseases like testicular cancer.
- Cryptorchidism cannot be prevented.
- Adults affected by this medical condition usually suffer from infertility.
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© 2016 Srikanth R