Cryptorchidism, cryptorchism

Definition: Incomplete descent of testis into base of scrotum

Unilateral or bilateral absence of testis in scrotum

Located anywhere from kidney to inguinal canal, inguinal canal most common (80%)

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  Bilateral in 10%

Ultrasound features: Ovoid homogeneous, hypoechoic, well-circumscribed structure smaller than normal descended testis

MR: Useful for detecting intraabdominal testis, if not seen by ultrasound

Inguinal lymphadenopathy

Inguinal hernia

Anorchia: Absent testis

Undescended testis: Arrest of testis along normal path of descent

Ectopic testis: Testis outside normal path of descent

Complications: Increased risk of testicular cancer (1:1,000-1:2,500), torsion, atrophy, infertility, and trauma

Treatment

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  Orchiopexy before age 2 to preserve fertility

  
  
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  Orchiectomy: Consider in patients aged 12-50 years

Start in high scrotal location and ask patient if palpable mass is present in inguinal region (most common location)

If still not found: (1) Follow spermatic cord upward: (2) Next, using transverse approach, check lower abdominal region near groin, iliac fossa, and pelvis and in abdominal region near kidneys