Cryptorchidism: Causes, Symptoms and Treatment
Cryptorchidism is a genital problem related to an undescended or poorly descended testicle. If it it isn’t treated in time, it can do enormous harm to the child in the future.
This genital development disorder doesn’t show up on a prenatal ultrasound before the 28th week of gestation. Therefore, to detect it early, a transinguinal migration must be performed.
What causes cryptorchidism to appear?
Cryptorchidism is one of the most common disorders in baby boys. The factors affecting its appearance are varied because there is no exact cause.
These are some of the most frequent elements that indicate a child could be suffering from this disorder:
- Low birth weight: This mainly happens when the baby has a premature birth. The weight is considered low when it’s less than 5.5 pounds.
- Preterm birth: These babies are born before the 37th week of pregnancy.
- Small for gestational age: the baby is considered smaller than he or she should be.
- Maternal exposure to estrogen during the first month of pregnancy: this is due to normal physical changes that occur during the first month of pregnancy.
- Intra-abdominal pressure: this refers to the pressure that occurs inside the abdominal cavity above 10 centimeters (about 4 inches).
- Malformations in the abdominal wall: a group of congenital malformations represent heterogeneous defects that cause herniation or evisceration of one or more organs in the abdominal cavity.
Diagnosis of cryptorchidism
The most common way to diagnose this disorder is through a doctor’s examination. The doctor will palpate the scrotal sac.
If the sac is empty, the index finger is run along the inguinal canal in the caudal direction, making a movement from top to bottom, to confirm if the testicle is in this path.
If the testes haven’t descended correctly or are ectopic, the probability of detecting it is 80%.
This evaluation should be performed routinely and, although it’s very effective, false cryptorchidism may occur due to a cremasteric reflex. Occasionally, doctors may perform an abdominal ultrasound, tomography or resonance to locate the testicle.
“The testicles begin to form from the sixth week of gestation in the abdominal area.”
Types of cryptorchidism
Several types of cryptorchidism exist. The pediatrician, according to his or her evaluation, will be the one in charge of determining the treatment to follow depending on the results.
These are the types of cryptorchidism that exist:
- Elevated testicle: this is reflected when the testicle isn’t in the scrotum, but can be manually lowered. It requires continuous evaluation.
- Ectopic testicle: this occurs when the testicle exists outside the inguinal canal. It usually appears in a subcutaneous location.
- Acquired undescended testicle: at first, the testes didn’t appear in the scrotum, but lowered during the first year of life and then went back up. This disorder requires follow-up until the age of 10.
- Absent testes: in this type of disorder, the testicle is neither in the scrotum nor in the inguinal canal or the abdomen. These cases require an ultrasound or surgical exploration.
- True cryptorchidism: this occurs when the testicle isn’t in the scrotum and can be felt in the inguinal canal, but it isn’t possible to make it descend.
Treatment of cryptorchidism
Most cases of cryptorchidism resolve spontaneously in the first year, so doctors recommend only observing the child and periodically checking to see if the testicles descend on their own.
If this doesn’t happen after one year of age, treatment should be considered. It can be hormonal or surgical.
Hormonal treatment
Currently, this treatment is less common. It consists of intramuscular administration of a hormone that promotes the descent of the testicle into the scrotum.
As a negative point, the results of this treatment aren’t always effective. The testicle will most likely rise again after the treatment. In addition, this type of treatment isn’t without side effects.
Surgical treatment
Surgery represents the most effective treatment available today. It consists of descending the testicle into the scrotum by means of an intervention called orchidopexy.
It’s recommended that it be performed before 18 months of age. The chance of success for this intervention is quite high.
Complications of cryptorchidism
Without timely treatment, this disorder can greatly affect the child’s health. Therefore, act quickly if you suspect your child has this anomaly in his genital area. Some of the complications that can occur include:
- Infertility
- Increased risk of suffering testicular cancer
- Testicular torsion
- Inguinal hernia
Cryptorchidism can cause harm to children if not treated in time, so parents should pay special attention if they suspect that their child suffers from this disorder. Communicate quickly with the family doctor, and perform all the relevant check-ups.
