Undescended testes

Definition

Also known as cryptorchidism, undescended testes is a congenital condition characterized by testicles that do not extend to the scrotum.

Description

In the fetus, the testes are in the abdomen. As development progresses they migrate downward through the groin and into the scrotum. This event takes place late in fetal development, during the eighth month of gestation. Thirty percent of premature boys have testes that have not yet made the full descent. Only 3-4% of full-term baby boys have undescended testes, and half of those complete the journey by the age of three months. Eighty percent of all undescended testes cases naturally correct themselves during the first year of life. Undescended testes that are not corrected can lead to sterility and an increased risk of testicular cancer.

Causes and symptoms

The cause of undescended testes is presently unknown, however its symptoms are quite apparent. One or all of the testicles can be undescended, therefore the testicles appear to be either missing or lopsided.

Diagnosis

The newborn examination always checks for testes in the scrotum. It they are not found, a search will be conducted, but not necessarily right away. In most cases, the testes will drop into place later. If the testes are present at all, they can be anywhere within a couple inches of the appropriate spot. In 5% of cases, one testis is completely absent. In 10%, the condition occurs on both sides. Presence of undescended testes is indicated by measuring the amount of gonadotropin hormone in the blood.

Treatment

Once it is determined that the testes will not naturally descend, surgery becomes necessary. The procedure is called an orchiopexy and is relatively simple once the testes are located. The surgery is usually performed when the boy is between one to two years old.

Prognosis

Undescended testes must be treated to eliminate the increased risk of testicular cancer and the possibility of sterility. Undescended testes are twice as likely to develop cancer. Ten percent of all testicular cancers are in undescended testes.

Key Terms

Cryptorchidism

Undescended testes.

Embryonic

Early stages of life in the womb.

Fetal

Refers to the fetus, also known in the first two months after conception as an embryo.

Orchiopexy

Surgical procedure that places the testicles in the scrotum.

For Your Information

Books

• Bennett, J. Claude, and Fred Plum, eds. Cecil Textbook of Medicine. Philadelphia: W. B. Saunders Co., 1996.

• Nelson Textbook of Pediatrics. Ed. Richard E. Behrman. Philadelphia: W. B. Saunders Co., 1996.

• Rajfer, Jacob. "Congenital Anomalies of the Testes and Scrotum." In Campbell's Urology ed Patrick C. Walsh, et al. Philadelphia: W. B. Saunders Co., 1998.

• Rozauski, Thomas, et al. "Surgery of the Scrotum and Testis in Children." In Campbell's Urology, ed. Patrick C. Walsh, et al. Philadelphia: W. B. Saunders Co., 1998.

Sources: Gale Encyclopedia of Medicine, Published December, 2002 by the Gale Group

The Essay Author is J. Ricker Polsdorfer MD.