A disturbed testicular descent, also called cryptorchidism, describes when one or both testicles are not present in the scrotum. Normally the testicles will move into the scrotum within the first 6 months after birth. If not, early treatment like hormone injection or surgery can prevent a further damage.
A disturbed testicular descent, which is called cryptorchidism in medical terms, is a condition when one or both testicles are temporarily or permanently outside of the scrotum. The reason of it is usually that the descent of the testis or testes has not been completed and they cannot move into scrotum successfully at the latest within the first year of birth. This often happens with premature infant boys.
Normally, testicles will move into the scrotum at the latest within the first year after birth. The cause of a disturbed testicular descent is still not totally clear, hormonal disorders are very likely involved. It’s well known that disturbed testicular descent happens more often to early-born than regular-born infants. However, there are other factors such as genetic problems, maternal health or environmental issues that can affect the hormone levels and the normal development of testicles. There are distinguishable types of cryptorchidism: 1) Retractile testis: it is located most of the time in the scrotum, but gets retracted in the inguinal canal due to an inordinate cremaster reflex. There is usually no treatment necessary. 2.) Gliding testis: it is located in the inguinal canal. It can be pulled in the scrotum by physical examination but then slides back. Hormonal therapy or surgery is necessary. 3.) Abdominal testis, inguinal testis, obstructed testis and ectopic testis: in those forms the testis is never located in the scrotum. Hormonal therapy or surgery is necessary. If a disturbed testicular descent is not found or cured earlier in time, the testicles may lose their function and lead to reduced fertility. At the same time, the risk of getting a testicle cancer may also increase in the affected testicle.
The treatment of a disturbed testicular descent includes a hormone therapy or a surgery. The hormone therapy can induce the undescended testicle to move into the scrotum, but its success rate is only about 20%. If the therapy does not work, then a surgery with fixation of the testicle into the scrotum is necessary. Depending on the localization of the testicle, surgery can also be first line therapy.
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