CRYPTORCHIDISM

 

Cryptorchidism is defined as the arrested development of the testis / testes along its normal course.

It is: Unilateral in about 75% of cases and

        Bilateral in 25%. Arrested descent may occur anywhere along its pathway from the retroperitoneum to the scrotum. 80% of undescended testes lie at or   

         below the level of the inguinal ring.

 

 

 

Unilateral cryptorchidism

 

 

Unilateral cryptorchidism

 

 

 

 

 

 

 

 

 

 

 

 

 

Bilateral cryptorchidism

Cryptorchidism in Prune Belly Syndrome

The diagnosis depends on Normal Testicular Descent into the scrotum.

The diagnosis is important as the testes degenerates histologically as early as 1-2 years of age. Both testes may be affected, even with a unilateral, undescended testis. Cryptorchidism results in an increased risk of infertility and testicular cancer. The risk of testicular malignancy is 10-40 fold higher in men with cryptorchidism than in normal men.

Cryptorchidism is the most frequent anomaly of an endocrine gland, with an incidence of 3.4% in the term newborn, and 0.8-1% at 1 year of age (1).
 

ASSOCIATIONS
  1. Prune-belly syndrome (bilateral cryptorchidism).
  2. Anorchia (bilateral cryptorchidism).
  3. Noonan's syndrome (agonadism or normal gonads).
  4. Trisomies 13, 18 and 21.
  5. Other associations include:
    • Aarskfog (facial-digital-genital)
    • Androgen insensitivity syndromes
    • Anencephaly
    • Cleft lip/palate (holoprosencephaly).
    • Cockayne syndrome
    • Cornelia de Lange syndrome
    • Cryptophthalamus
    • Dubowitz syndrome
    • Hypopituitarism
    • Kallman's syndrome
    • Laurence-Moon-Biedl
    • Lowe (oculocerebrorenal) syndrome
    • Meckel-Gruber syndrome
    • Noonan syndrome
    • Optiz syndrome
    • Pituitary aplasia-hypoplasia
    • Prader-Willi syndrome
    • Prune-belly syndrome
    • Roberts syndrome
    • Rubinstein-Taybi syndrome
    • Septic-optic-dysplasia
    • Smith-Lemli-Optiz syndrome
    • Testicular enzymatic defects
    • Triploidy
    • Trisomy 13
    • Trisomy 18
    • 4p - (Wolf-Hirschhorn)
    • 5-a-reductase deficiency
    • 13 q
    • 18 q

 

 

REFERENCES
  1. Desgrandchamps F. Undescended testes. Current stage of knowledge. J Urol (Paris) 1990;96:407-414.
  2. Rajfer J. Congenital Anomalies of the testis. In: Walsk DC, Retick AB, Saney TA, et al. Campbell's Urology. W. B. Saunders, Harcourt, 6th edition, 1992, pp. 1543-1562.
  3. Bartone FF, Schmidt MA: Cryptorchidism: incidence of chromosomal anomalies in 50 cases. J Urol 1992;127:1105.
  4. Bishop MC, Whitaken, RH. Associated renal anomalies in familial cryptorquidism (letter). Lancet 1079;2:249.
  5. Czeizel A, Erodi E, Toth J. Genetics of undescended testis. J Urol 1981;126:528-529.
  6.  Geffner ME, Lippe BM: Genetic and endocrinologic syndromes associated with cryptorchidism. in The undescended testis. Ed. EW Fonkalsrud, W. Mendel. Chicago, Year Book Medical Publisher, 1981