Cryptorchidism: Definition and Treatment

It is a testicle not descended.

When the testicle is formed in the abdomen, even after birth some testicles can go down to the normal position in the scrotum (most of them go down at 4 months of age). If the testicle is not in the scrotum at 6 months of age, it is unlikely that it can go down. This testicle is also called an undescended testicle. If the testicle can not be felt at all, it is called ” testicle cryptorchidism .” An undescended testicle requires surgery, called “orchidopexy,” to place in the scrotum.

Why is surgery necessary for cryptorchidism?

There are several reasons to place an undescended testicle in the scrotum.

Fertility: The temperature in the scrotum is lower than in the abdomen. We know that the sperm-producing cells in the testicle do better if they are in the cooler scrotal environment. So placing the testicle in the scrotum at a young age can improve the quality and fertility possibilities in the future semen.

Cancer: Undescended testes have a higher chance of developing cancer later on. It is not clear if the early placement of the testicle in the scrotum decreases the probability of having cancer . The placement of the testes in the scrotum does allow self-examination of the testicles and early detection of testicular cancer if it occurs.

Hernia: A hernia sac is almost always associated with an undescended testicle. During the operation to bring the testicle down, this hernia is identified and fixed routinely.

When should the surgery be done?

Since some testicles that do not descend, at birth will go down, it is best to wait until around 6 months of age. At this age, if a testicle can not be felt or is very high, it is unlikely that it can go down, then it is time to think about surgery.

How is the surgery?

In most cases, the child will go home the same day as the surgery, which is carried out through a small incision in the groin and scrotum. There are no stitches. In some children, when the testicle can not be felt (cryptorchidism), laparoscopy can be used. Laparoscopy involves making an incision in the abdomen and placing a light telescope through this incision to look for the missing testicle.

What are some of the specific complications with orchidopexy?

Infection or bleeding of the wound, can occur with any operation. Injury to the testicular blood vessels or the vas deferens (the conduit that carries the sperm) can occur when an orchiopexy is performed . These structures are delicate and avoiding harm requires delicacy and precision while the surgery is being performed. Rarely, there are some testicles that do not reach the scrotum after the first surgery and require a second incision (one year later) to put them in their normal scrotal position.