Cryptorchidism: Everything You Need to Know

When a child's testicles don't descend towards the scrotum naturally, this is considered abnormal. This is a common disorder known as cryptorchidism. What does it involve? Is there a way to prevent it? Today we'll look at these questions a bit more. 
Cryptorchidism: Everything You Need to Know

Last update: 12 April, 2019

Normally, a baby’s testicles relocate to his scrotum sack during the seventh month of pregnancy. However, about 3% of male babies present a condition known as cryptorchidism – meaning one or both of the testicles haven’t descended.

In 98% of these cases, testicles descend naturally during the first year of life. But what can be done if this doesn’t occur?

What is cryptorchidism?

The term cryptorchidism is a compound word with Greek origins that means “hidden testicle.” It’s a disorder that occurs when one or both testicles fail to descend  completely.

This descent should take place during the final stage of pregnancy. However, with cryptorchidism, one or both testicles fail to make it to their final destination. They may remain in the inguinal canal, in the entrance to the scrotum sac, the scrotum or the abdomen.

Possible causes of cryptorchidism

A baby’s testicles should descend to the scrotum sack on their own by the time he’s 9 months old. Some of the possible causes of undescended testicles are the following, though other causes remain unknown:

  • Fetal malformations.
  • Genetic problems, such as hormonal deficiencies related to the pituitary gland or the hypothalamus.
  • Anatomical defects.
  • Premature birth.
  • Low birth weight.
  • Family medical history of cryptorchidism.
  • Alcohol or tobacco consumption by the mother during pregnancy.
  • Exposure of the parents to certain pesticides.
Cryptorchidism: Everything You Need to Know

How does diagnosis of cryptorchidism take place?

Symptoms of undescended testicles aren’t present from the beginning. Rather, they can be observed after birth. At this point, doctors are unable to palpate one or both testes in the scrotum sack.

The specialist who is responsible for diagnosing this condition can be either a child urologist or a pediatric surgeon. By performing a precise palpation, doctors can determine the position of the testicles.

Your child’s doctor will also carry out other exams if he or she is unable to detect the location of the testes through palpation. These tests include a test to stimulate hormones and a laparoscopy involving general anesthesiaIn more delicate cases, medical professionals may also call for an ultrasound or an MRI.

If a child’s testicles fail to descend on their own during the first months of life, doctors recommend the following treatment options :

Hormonal therapy

To resolve the issue through hormonal therapy, doctors administer hormones like human chorionic gonadotropin (hCG) or the gonadotropin-releasing hormone (GnRH). These help release testosterone which, at the same time, is responsible for causing testicles to descend.

A specialist will inject hCG in the baby’s muscle or administer GnRH through a nasal spray. Over the course of treatment, both hormones can be combined.

“Cryptorchidism is a disorder that occurs when one or both testicles fail to descend completely.”

Surgical intervention

An operation known as orchiopexy is another alternative for treating cryptorchidism. Here, a specialist makes a small incision in the groin. Then, he or she frees the spermatic cord and immediately pulls it downward.

Finally, the surgeon will firmly sew the testicles into the deepest part of the scrotum sack. This intervention only takes place in cases where hormonal treatment is unsuccessful, the position of the testicles is abnormal, or an inguinal hernia is present.

Cryptorchidism: Everything You Need to Know

5 serious consequences of not treating cryptorchidism in time

Delayed treatment of undescended testicles can, over time, cause serious damage to testicular tissue. This is because of their abnormal position. Some of the consequences we can mention are the following:

  • Inguinal hernia: This malformation of the testicles increases the risk of the appearance of a hernia in the groin.
  • Testicular torsion: When the testes and the spermatic cord suffer twisting, this produces an acute circulatory disorder. In general, it requires immediate treatment involving surgical intervention.
  • Testicular compression: This results from the injuries that appear in the area where one or both testicles are trapped
  • Infertility: If treatment doesn’t take place in time, it can result in damage to the testicular tissue. As a result, the testes will produce few sperm.
  • Testicular cancer: This can take place if treatment takes place very late, or if cryptorchidism goes untreated altogether. In adulthood, these individuals run a greater risk of developing this type of cancer.

Remember that, if cryptorchidism doesn’t correct itself within the first 6 months of life, treatment is necessary. This treatment should be over by the time a baby reaches his first birthday.

As parents, we must examine our children constantly during their first month of life, after six months, after the first year and until puberty. That way, you can avoid major long-term consequences.

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This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.