by Ingrid Walter

Created on: September 01, 2009

What is an undescended testicle?

An undescended testes is medically known as cryptorchidism. The word cryptorchidism is derived from the Greek words kryptikos ("hidden") and orchis ("testis"). Cryptorchidism is the most common male reproductive disorder that occurs at birth. It is a congenital disorder where one or both of the testes fail to descend into the scrotum. The initial development of the male reproductive organs starts before birth when the reproductive tract differentiates into male instead of the female. Typically, the testes in the male fetus are in the upper abdomen near the kidneys and during the last few weeks of gestation (approximately 2 months before birth) they descend into the scrotum. A number of newborns and about one-third of premature babies are born with this condition.

Factors that predispose to cryptorchidism are prematurity, low birth weight, small for gestation age, and multiple gestations. Failure of the testes to descend may be caused by hormonal imbalances in the developing fetus or by a physical obstruction or deficiency. Cryptorchidism can be detected early in a newborn during the initial physical assessment of the newborn. This is done by gently palpating the newborns scrotum to feel for the testes. However, sometimes it can be difficult to detect especially if the testes are not in the normal genitourinary tract. This is called ectopic cryptorchidism.

Majority of the undescended testes will spontaneously descend into the scrotal sack within the first year of life. Usually by six months. However, if this does not happen, medical management is considered. Surgery (orchiopexy) can be considered as an option if the testes will not have descended at two years of age.

Undescended testes may be a cause of anxiety to many parents, particularly pre-pubertal boys because of risk of sterility. This is because the higher temperature in the body inhibits Spermatogenesis - formation of sperms- from taking place.

Medical management is by either hormonal treatment by injection of testosterone or HCG (human chorionic gonadotrophin) or by surgical correction. Early hormonal treatment may stimulate the testes to descend resulting in normal testicular and sexual development. HCG is the drug of choice. If therapy does not work within 5 weeks surgery is the only option. During orchiopexy a small cut is made in the inguinal regions the area near the groin and the testes are brought down, the procedure is done on an out-patient basis. The patient recovers within a period of one week.

The major complication of undescended testes whether or not treatment has been initiated is sterility, and tumors or cancers of the testes may also occur. Therefore, the pubertal boy should be taught on how to perform self testicular exams each and every month, ultrasound examinations should also be considered in case of a detected defect.

Cryptorchidism is a condition that may cause great grief to a family and embarrassment to the teenager. If the parents are unable to talk to the son it is advisable to seek professional help, somebody who can communicate easily with the patient and help them deal with the feelings that they are having.

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