Cryptorchidism

Posted by e-Medical PPT Saturday, June 26, 2010

Cryptorchidism is the condition that absence of one or both testes from the scrotum. This usually represents failure of the testis descend, during fetal development from an abdominal position, through the inguinal canal, into the ipsilateral scrotum. About 3% of full-term and 30% of premature infant boys are born with at least one undescended testis, making cryptorchidism the most common birth defect of male genitalia. However, about 80% of cryptorchid testes descend by the first year of life , making the true incidence of cryptorchidism around 1% overall.
Approximately 80% of undescended testes are palpable and 20% are nonpalpable.19 Nonpalpable testes may be intra-abdominal or absent. Palpable testes may be undescended, ectopic, or retractile.Approximately 20-30% of patients with cryptorchidism have nonpalpable testes. Most intra-abdominal testes are found within a few centimeters of the internal ring. Absent or vanishing testes are thought to be due to an intrauterine or perinatal vascular event, most likely during late gestation since most of these testicular nubbins are found below the internal inguinal ring. Only 20-40% of nonpalpable testes are absent upon surgical exploration.
Undescended testes are associated with reduced fertility, increased risk of testicular germ cell tumors and psychological problems when the boy is grown. Undescended testes are also more susceptible to testicular torsion and infarction and inguinal hernias. To reduce these risks, undescended testes are usually brought into the scrotum in infancy by a surgical procedure called an Orchiopexy.
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