Cryptorchidism

Published on 10/06/2015 by admin

Filed under Pediatrics

Last modified 10/06/2015

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Cryptorchidism

Ronald Rabinowitz, MD , William Hulbert, MD , Robert Mevorach, MD

Basic Information

Definition

Cryptorchidism is failure of the testis to completely descend into the scrotum. The term is derived from the Greek words kryptos and orchis, meaning “hidden testis.”

Synonyms

Incompletely descended testis
Undescended testis

ICD-9-CM Code

752.51 Undescended testis

Epidemiology & Demographics

• Incidence is related to gestational age because testes descend late in fetal growth.

image Cryptorchidism occurs in up to 30% of preterm infants.
image The incidence is 1 (3%) in 33 term newborns.
image A less than 1% incidence is seen after age 6 months.

• Five percent of cases are nonpalpable.
• Distribution is 65% right, 25% left, and 10% bilateral.
• Approximately 80% of cases are identified at birth, whereas 20% manifest later in childhood.
• Cryptorchidism is associated with many central nervous system anomalies, including the following:

image Myelomeningocele
image Hydrocephalus
image Anencephaly
image Hypopituitarism

• It is associated with abdominal wall defects such as prune-belly syndrome and gastroschisis.
• The incidence is increased among premature infants and small-for-gestational-age (SGA) infants.
• Increased familial incidence (10% of siblings) is observed.
• There is an increased incidence of testicular malignancy in maldescended testes.
• The risk for impaired fertility is increased for those with undescended testes.
• Increased incidence of cryptorchidism is associated with multiple malformation syndromes, including chromosomal anomalies and single-gene defects.

Clinical Presentation

History

• Cryptorchidism is usually identified on physical examination.
• It is not associated with pain, tenderness, or discomfort in most cases.
• Many malformation syndromes, chromosomal abnormalities, and neurologic defects are associated with maldescended testes, including the following:

image Aarskog syndrome
image de Lange’s syndrome
image Kallmann’s syndrome
image Klinefelter syndrome
image Laurence-Moon-Biedl syndrome
image Noonan-Opitz-Frias syndrome
image Prader-Willi syndrome
image Robinow’s syndrome
image Rubinstein-Taybi syndrome
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