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Undescended Testicle
Aka: Undescended Testicle, Undescended Testes, Undescended Testis, Cryptorchidism
- See Also
- Genitourinary Examination in Infants
- Testes
- Definition
- Cryptorchidism: "Hidden Testicle"
- Epidemiology: Incidence
- Preterm Newborn: 30% Incidence
- Term Newborn: 2.7 to 5.9% Incidence
- Age 6 months: 0.8% persistent Undescended Testicle
- Bilateral Undescended Testes in 10-20% of cases
- Differential Diagnosis: Bilateral Undescended Testicle
- Congenital Adrenal Hyperplasia (female Virilization)
- Diagnostics: Bilateral Crytorchidism
- Pelvic Ultrasound
- Karyotype
- Labs: Bilateral Crytorchidism
- Serum Testosterone
- Luteinizing Hormone (LH)
- Follicle Stimulating Hormone (FSH)
- Thyroid Stimulating Hormone
- 17-Hydroxyprogesterone
- Mullerian-Inhibiting Substance
- Serum Cortisol
- Thyroid Stimulating Hormone
- Management
- Initial Referral Indications
- Bilateral Undescended Testes
- Associated genitourinary abnormalities
- Unilateral retracted Testicle
- Testicle may be brought down into Scrotum
- Parents pull Testis into Scrotum per diaper change
- Follow-up examinations in the clinic
- Unilateral palpable ectopic or Undescended Testicle
- Observe for descent
- Surgical correction at 6 month to 1 year
- Unilateral nonpalpable Testicle (15% of cases)
- Laparoscopy at 6 months to 1 year for evaluation
- Testicle found on laparoscopy in 50% of cases
- Orchiopexy brings Testis into Scrotum (98% efficacy)
- Complications: Untreated
- Testicular Cancer (Seminoma) at age 15 to 45 years
- Unilateral Undescended Testicle risk: 1 in 80
- Bilateral Undescended Testicle risk: 1 in 50
- Infertility
- Indirect Inguinal Hernia (often present)
- Testicular Torsion (of cryptorchid Testicle)
- Prognosis: Fertility
- Repaired unilateral Cryptorchidism: 50-65% fertile
- Repaired bilateral Cryptorchidism: 85% fertile
- References
- Behrman (2000) Nelson Pediatrics, Saunders, p. 1650-1
- Docimo (2000) Am Fam Physician 62(9):2037-48 [PubMed]
- Fuloria (2002) Am Fam Physician 65(2):265-70 [PubMed]