What is Cryptorchidism? Symptoms and Treatment

What is Cryptorchidism?

Cryptorchidism is a testicle that has not moved into its proper position in the scrotum before birth. Usually, just one testicle is affected, but about 10 percent of the time, both testicles are undescended. This condition is uncommon in general but common among baby boys born prematurely. It moves into the proper position on its own within the first few months of life. However, an infant sometimes needs surgery to relocate the testicle to the scrotum. Some conditions that result in absent testicles can cause serious medical problems soon after birth if left undiagnosed and untreated.

What are the Symptoms of Cryptorchidism?

Not seeing or feeling a testicle where you would expect it to be in the scrotum is the main sign of this condition. During the last couple of months of normal fetal growth, the testicles gradually move down from the abdomen through a tube-like passageway in the groin into the scrotum. With an undescended testicle, that process stops or is delayed. If a doctor cannot feel the testicle, it is unpalpable, and it may be:

1. Inguinal. The testicle has moved into the inguinal canal, but not far enough to be detectable by touch.
2. Atrophic or absent. The testicle is either very small or has never formed.
3. Abdominal. The least common location for an undescended testicle is in the abdomen.

Treating an undescended testicle when your son is still a baby might lower the risk of complications later in life. See your doctor if the condition indicates:

A retractile testicle, which moves back and forth between the scrotum and the groin and might be easily guided by hand into the scrotum during a physical exam. 

An ascending testicle, or acquired undescended testicle, that has returned to the groin and can’t be easily guided by hand into the scrotum.

The Common Risk Factors of Cryptorchidism

• Alcohol use by the mother during pregnancy
• Cigarette smoking by the mother during pregnancy 
• Exposure of the mother to secondhand smoke
• Family history of undescended testicles 
• Family history of genital development problems
• Conditions of the fetus that can restrict
• Exposure to some pesticides
• Low birth weight
• Premature birth
• Down syndrome or an abdominal wall defect

Cryptorchidism may increase your risk of developing fertility problems such as low sperm count or quality. This can be due to abnormal development of the testicle and might get worse if the condition goes untreated for an extended period of time.

How to Diagnose Cryptorchidism?

If your son has this condition, the doctor may recommend surgery to determine the diagnosis and possible plan of treatment. Diagnostic methods include:

Laparoscopy. It is done to locate an intra-abdominal testicle. The doctor might be able to fix the undescended testicle during the same procedure, but additional surgery might be needed in some cases. 

Open surgery. Direct exploration of the abdomen or groin through a larger incision might be necessary in some cases.

Treatment for Cryptorchidism

The goal of treatment is to move the undescended testicle to its proper location in the scrotum. Treating the condition before the child turns one year old may lower the risk of complications of an undescended testicle, such as infertility and testicular cancer.

Surgery is also a treatment recommended to correct undescended testicles. This procedure can be done either with a laparoscope or with open surgery. When your son has surgery will depend on a number of factors, such as his health and how difficult the procedure might be. Discuss with your doctor the possible risk and benefits of surgery.

Hormone Treatment of Cryptorchidism using HCG

HCG is a hormone produced by the placenta during pregnancy. It helps thicken a woman’s uterine lining to support a growing embryo and tells the body to stop menstruation. This hormone is also used for several conditions, including cryptorchidism. It could cause the testicle to move to your son’s scrotum.