Cryptorchidism


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Introduction

Cryptorchidism is a disorder where either one or both testes fail to descend and are therefore absent from the scrotum.  This usually occurs during foetal development when the testes begin their movement or descent from an abdominal position through the inguinal canal into the scrotum. Because the testes have failed to descend and therefore remain within the body, the temperature is too hot for sperm production to occur, rendering the male infertile.

There are however varying levels of cryptorchidism:

• Undescended testicles may later fully descend (usually within 1 year) leaving the male without fertility problems

• Testicles which have not fully descended but have partially reached the scrotum may be able to produce some sperm

• Only on testicle may not descend, but as the other will have fully descended the male will be fertile

• If both testicles fail to descend (bilaterally cryptorchid testes) then the male is infertile

Only sperm production is affected however (due to the high body temperature) which means that the natural hormone production of the testes are unaffected, the male will still behave normally therefore and express normal sexual behaviour.

The possible outcomes of testes failure to descend:

• Testis could be found anywhere along the “path of descent” from high in the posterior (retroperitoneal) abdomen, just below the kidney, to the inguinal ring

• Testis could be found in the inguinal canal

• Testis could be 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

• Testis could be undeveloped (hypoplastic) or severely abnormal (dysgenetic);

• Testis could have vanished – May therefore be anorchid or monorchid (Not formed)

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