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Undescended TesticleAka: Undescended Testes, Undescended Testis, Cryptorchidism

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  1. See Also
    1. Genitourinary Examination in Infants
    2. Testes
  2. Definition
    1. Cryptorchidism: "Hidden Testicle"
  3. Epidemiology: Incidence
    1. Preterm Newborn: 30% Incidence
    2. Term Newborn: 2.7 to 5.9% Incidence
    3. Age 6 months: 0.8% persistent undescended Testicle
    4. Bilateral undescended Testes in 10-20% of cases
  4. Differential Diagnosis: Bilateral Undescended Testicle
    1. Congenital Adrenal Hyperplasia (female virilization)
  5. Diagnostics: Bilateral Crytorchidism
    1. Pelvic ultrasound
    2. Karyotype
  6. Labs: Bilateral Crytorchidism
    1. Serum Testosterone
    2. Luteinizing hormone (LH)
    3. Follicle Stimulating Hormone (FSH)
    4. Thyroid Stimulating Hormone
    5. 17-Hydroxyprogesterone
    6. Mullerian-Inhibiting Substance
    7. Serum Cortisol
    8. Thyroid Stimulating Hormone
  7. Management
    1. Initial Referral Indications
      1. Bilateral undescended Testes
      2. Associated genitourinary abnormalities
    2. Unilateral retracted Testicle
      1. Testicle may be brought down into scrotum
      2. Parents pull Testis into scrotum per diaper change
      3. Follow-up examinations in the clinic
    3. Unilateral palpable ectopic or undescended Testicle
      1. Observe for descent
      2. Surgical correction at 6 month to 1 year
    4. Unilateral nonpalpable Testicle (15% of cases)
      1. Laparoscopy at 6 months to 1 year for evaluation
      2. Testicle found on laparoscopy in 50% of cases
      3. Orchiopexy brings Testis into scrotum (98% efficacy)
  8. Complications: Untreated
    1. Testicular Cancer (Seminoma) at age 15 to 45 years
      1. Unilateral undescended Testicle risk: 1 in 80
      2. Bilateral undescended Testicle risk: 1 in 50
    2. Infertility
    3. Indirect Inguinal Hernia (often present)
    4. Testicular Torsion (of cryptorchid Testicle)
  9. Prognosis: Fertility
    1. Repaired unilateral cryptorchidism: 50-65% fertile
    2. Repaired bilateral cryptorchidism: 85% fertile
  10. References
    1. Behrman (2000) Nelson Pediatrics, Saunders, p. 1650-1
    2. Docimo (2000) Am Fam Physician 62(9):2037
    3. Fuloria (2002) Am Fam Physician 65(2):265

Cryptorchidism (C0010417)

Definition (MSH)A developmental defect in which a TESTIS or both TESTES failed to descend from high in the ABDOMEN to the bottom of the SCROTUM. Testicular descent is essential to normal SPERMATOGENESIS which requires temperature lower than the BODY TEMPERATURE. Cryptorchidism can be subclassified by the location of the maldescended testis.
Definition (CSP)failure of testes to descend into scrotum.
Definition (NCI)A condition in which one or both testicles fail to move from the abdomen, where they develop before birth, into the scrotum. Undescended testicles may increase the risk for development of testicular cancer.
ConceptsCongenital Abnormality (T019)
ICD9752.51
DanishRetentio testis/kryptorkisme
DutchCryptorch/niet ingedaalde testis
EnglishCryptorchidism, Cryptorchism, Imperfectly descended testis, Maldescent of testis, Undesc testicle/cryptorchism, Undescended Testes, Undescended testicle, Undescended testicle/cryptorchism, undescended testicles, Undescended Testis
FinnishKIVEKSEN LASKEUTUMATTOMUUS/PIILOKIVEKSISYYS
FrenchTesticule ectopique/cryptorchidie
GermanMaldescension/Kryptorchismus
Hebrewkriptorxidizem
Hungariancryptorchismus/nem leszallt here
ItalianTesticolo ritenuto/criptorchidismo
NorwegianRETINERT TESTIS/KRYPTORKISME
PortugueseTesticulo nao descido/criptorq
Spanishcriptorquidia, testículo maldescendido, testículo no descendido, testiculo maldescendido, Testiculo no desc/criptorquidia, testiculo no descendido
SwedishRETINERAD TESTIKEL/KRYPTORKISM
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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