Sandbox MWH
Cryptorchidism
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Muhammad Waleed Haider, M.D.[2]
Synonyms and Keywords: Cryptorchism; maldescended testis; ectopic testis; undescended testicle
Historical Perspective
Cryptorchidism is derived from the Greek words "crypto" (meaning "hidden") and "orchid" (meaning "testicle"). During the last century, cryptorchidism was sometimes restricted to the subset of undescended testes that were not palpable above the scrotum or in the inguinal canal — those that were truly hidden in the abdomen or completely absent. In recent decades the distinction is no longer made in most contexts, and the two terms are used interchangeably. Cryptorchism is an older variant of the same term.
Pathophysiology
The testes begin as an immigration of primordial germ cells into testicular cords along the genital ridge in the abdomen of the early embryo.
A testis absent from the normal scrotal position can be:
- Found anywhere along the "path of descent" from high in the posterior (retroperitoneal) abdomen, just below the kidney, to the inguinal ring
- Found in the inguinal canal
- Ectopic, that is, found to have "wandered" from that path, usually outside the inguinal canal and sometimes even under the skin of the thigh, the perineum, the opposite scrotum, and femoral canal
- Found to be undeveloped (hypoplastic) or severely abnormal (dysgenetic)
- Found to have vanished (also see Anorchia)
About two thirds of cases without other abnormalities are unilateral; 1/3 involve both testes. In 90% of cases an undescended testis can be palpate (felt) in the inguinal canal; in a minority the testis or testes are in the abdomen or nonexistent (truly "hidden").
Associated Conditions[edit | edit source]
Cryptorchidism occurs at a much higher rate in a large number of congenital malformation syndromes. Among the more common are:
- Cloacal exystrophy
- Noonan syndrome
- Prader- willi syndrome