Urology Book

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Undescended Testicle

Aka: Undescended Testicle, Undescended Testes, Undescended Testis, Cryptorchidism
  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):2037-48 [PubMed]
    3. Fuloria (2002) Am Fam Physician 65(2):265-70 [PubMed]

Cryptorchidism (C0010417)

Definition (NCI_NCI-GLOSS) 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.
Definition (NCI) The failure of one or both testes of a male fetus to descend from the abdomen into the scrotum during the late part of pregnancy. If not surgically corrected in early childhood, males may be at increased risk for testicular cancer later in life.
Definition (CSP) failure of testes to descend into scrotum.
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.
Concepts Congenital Abnormality (T019)
MSH D003456
ICD9 752.51
ICD10 Q53, Q53.9
SnomedCT 367721002, 204879009, 156967003, 37501009, 268226005, 204882004, 204878001
English Cryptorchism, Testis, Undescended, Testes, Undescended, Undescended Testes, CRYPTORCHISM, Cryptorchidism, UNDESCENDED TESTICLE, Undescended testicle NOS, Cryptorchidism NOS, Undescended testicle, unspecified, UNDESCENDED TESTIS, Cryptorchidism (unilateral or bilateral), CRYPTORCHIDISM, UNILATERAL OR BILATERAL, IDT - Imperf descended testis, testes cryptorchism, undescended testicle, cryptorchidism, cryptorchism, undescended testicle (diagnosis), cryptorchidism (physical finding), cryptorchism was observed, Maldescended testis, Maldescended testicle, Testicle maldescended, Testicle undescended, Cryptorchism NOS, Cryptorchidism [Disease/Finding], maldescent of testis, undescend testicle, undescended testis, testicle undescended, testes undescend, maldescended testis, testicles undescended, undescended testes, Cryptorchidism, Unilateral Or Bilateral, Undescended Testis, Undescended testis (disorder), Undescended testicle NOS (disorder), Cryptorchism (disorder), Cryptorchidism NOS (disorder), Retained testicle, Cryptorchid, undescended testicles, Undescended Testicle, Undescended testis, Undescended testicle, Imperfectly descended testis, Maldescent of testis, IDT - Imperfectly descended testis, UDT - Undescended testes, Undescended testicle (disorder), maldescent; testis, nondescent; testicle, testicle; nondescent, Undescended testis (disorder) [Ambiguous], Undescended testis (body structure)
French CRYPTORCHIDIE, Ectopie testiculaire, Testicule mal descendue, Testicule non descendue, Cryptochirdie d'un testicule, Testicule mal descendu, ECTOPIE TESTICULAIRE, Cryptorchidie unilatérale ou bilatérale, Cryptorchisme, Cryptorchidie, Testicule non descendu
German KRYPTORCHISMUS, Maldescensus testis, Hoden nicht abgestiegen, gestoerter Hodenabstieg, Hodenabstieg gestoert, nicht abgestiegener Hoden, HODENHOCHSTAND, Nondescensus testis, nicht naeher bezeichnet, Nondescensus testis, Hodenhochstand, Kryptorchismus
Dutch niet-ingedaalde testikels, cryptorchidisme, slecht ingedaalde testikel, slecht ingedaalde testis, niet-ingedaalde testis, niet-ingedaalde testikel, Niet ingedaalde testis, maldescensus; testis, niet indalen; testis, testis; niet indalen, Niet ingedaalde testis, niet gespecificeerd, cryptorchisme, Cryptorchisme, Testis, niet ingedaalde
Italian Testicolo non disceso e retrattile, Testicolo ritenuto, Testicoli ritenuti, Criptorchismo, Criptorchidismo
Portuguese Testículo mal descido, Criptorquidia, Testículo não descido, CRIPTORQUIDIA, ECTOPIA TESTICULAR, Testículo Abdominal, Testículo não Descido, Testículo Inguinal, Criptorquismo, Criptorquidismo, Testículo Retido
Spanish Testículo mal descendido, Testículo inadecuadamente descendido, Descenso anómalo del testículo, Testículo no descendido, CRIPTORQUIDIA, criptorquidia, SAI (trastorno), criptorquidia (trastorno), criptorquidia, criptorquidia, SAI, falta de descenso testicular, SAI, falta de descenso testicular, SAI (trastorno), criptorquidia (concepto no activo), testículo no descendido (trastorno), testículo no descendido, Criptorquidia, testículo maldescendido, Criptorquidismo, Testículo no Descendido
Japanese 下降不良精巣, ﾃｲﾘｭｳｾｲｿｳ, ｶｺｳﾌﾘｮｳｾｲｿｳ, 高位睾丸, 停留精巣, 停留睾丸, 潜伏睾丸, 潜伏睾丸症, 潜伏精巣, 潜在睾丸, 潜在睾丸症, 潜在精巣, 潜在精巣症, 睾丸下降不全, 鼠径睾丸, 鼠径精巣, 睾丸-停留, 精巣-停留
Swedish Kryptorkism
Czech kryptorchismus, Nesestouplé varle, Nedokonale sestouplé varle, Kryptorchismus, nesestouplé varle
Finnish Piilokiveksisyys
Russian KRIPTORKHIZM, KRIPTORKHIDIZM, IAICHKO NEOPUSTIVSHEESIA, КРИПТОРХИДИЗМ, КРИПТОРХИЗМ, ЯИЧКО НЕОПУСТИВШЕЕСЯ
Korean 정류 고환, 상세불명의 정류 고환
Croatian KRIPTORHIZAM
Polish Wnętrostwo, Jądro niezstąpione
Hungarian Cryptorchismus, Retentio testis, Maldescendus here, Testis maldescendus, Helytelenül leszállt here, Le nem szállt testis, Rejtettheréjűség, Le nem szállt here
Norwegian Testikkelretensjon, Testisretensjon, Kryptorkisme
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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