Cryptorchidism

Cryptorchidism

Cryptorchidism is the condition in which the testicle is unable to descend to its normal position within that scrotal cavity.

This situation is different from the ectopic testis, which descends while normally through the inguinal canal, does not result in the scrotum, but it is found in an abnormal position (abdominal, Perineal, umbilical and lateralis) and by anaspomeno testis, the that is normal testicle which sometimes passes into the inguinal canal.

Cryptorchidism – Aetiology

Anatomical (occlusion inguinal canal, great length epididymis, partial or total atresia; short length of sperm pore), functional, genetic and hormonal disorders have occasionally suggested possible causes of incomplete descent of the testis.

Cryptorchidism – Diagnosis

Usually, diagnosis of cryptorchidism is easy. The absence of the testis from the scrotum, clearly establishes the clinical examination of the patient, who should be examed at a peaceful environment.

The difficulty often lies in locating the testicle, which is usually found in some point of the path between the abdominal cavity and scrotum. The most common site is groin.

In cases where the testicle is not found by clinical examination, the urologist uses other tests such as ultrasound, computed tomography or laparoscopy or Tc99 spinthirogam in cases of intra-abdominal testes.

Parents should notice that the testicle can descend up to one year after the birth of the boy, and for this reason any decision on a possible interference should be taken after this time.

Cryptorchidism – Treatment

It is primarily surgical and consists in finding and preparing the testis, placing it within the cavity of the scrotum and the fixation of the scrotum before completing 2 years, as early treatment of cryptorchidism is that it can reduce ectopic testes’ complications.

Complications that may occur include:

1.  Severe histopathological lesions rendered non-functional in terms of sperm production
2.  Twisted ectopic testis
3.  Disorder due to immunological mechanisms’ operation and the other testicle , causing infertility
4.  The ectopic testis is 20-40 times more likely to develop cancer (seminoma of the testis) after the lapse of several years.

Hormonal therapy with hCG administration form for a short period of time helps many testis descent.

Thus it has been proposed to administer hormone (LHRH) for 4 weeks, in the form of spray, daily from the age of 10 months. If this scheme fails, the recommended weekly administration 1500 units hcG for 3 weeks.

If this fails and then necessitating the surgery.

However, the medical community is still controversy on the issue of hormone therapy and many are those who argue that only the mobile testes respond to it and not boys and cryptorchidism.