Cryptorchidism: summary table

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Disorder	Cryptorchidism: failure of one or both testicles to descend into the scrotal bursa, as they are retained in the inguinal canal or within the abdominal cavity
Etymology of the term	From the Greek: cryptorchidism root: cripto- κρυπτος (hidden) ending όρχυς (testicle)
Genital disorders related to cryptorchidism	Cryptorchid testicle: located outside the scrotum Ectopic testicle: it is diverted to an anomalous location (eg perianal or femoral locus) Retractable testicle: it rises from time to time near the external inguinal ring, although normally descended inside the scrotal sac Palpable testicle Not palpable testicle
Incidence of cryptorchidism	It represents the most frequent anomaly that affects the urogenital system of infants and infants Incidence varying from 9 to 30% among pre-term newborns Incidence varying from 3 to 5% among children born within the established term Often, cryptorchidism regresses spontaneously in the first or second year of a child's life Unilateral cryptorchidism in 60-65% of cases Bilateral cryptorchidism in 30-35% of cases 10-20% more likely to contract testicular cancer than the normal one among subjects suffering from cryptorchidism The abdominal cryptorchid testes are 4 times more at risk of neoplastic evolution than those located near the inguinal canal
Embryogenesis	1st-8th week: testicular differentiation in the upper lumbar area 8th - 12th week beginning of migration of the testicles towards the scrotum 3rd month - 7th month: the testicles reach the deep inguinal ring and the inguinal canal 9th month: the testicles are located inside the scrotal sac
Classification of cryptorchidism	True cryptorchidism (undescended testicle) Ectopic cryptorchidism Cryptorchidism with retractable testicle Cryptorchidism with incomplete testicle descent Anorchia: absence of both testicles Acquired cryptorchidism (following an inguinal hernia)
Etiopathological framework of cryptorchidism	Hormonal dysfunctions at the hypothalamic and pituitary level Genetic mutation of a particular peptide, known as INSL3 (factor 3-insulin-like) Hypospadias and micropenis Retraction of gubernaculum testis Testicular dysgenesis syndrome Acquired cryptorchidism: due to surgery for inguinal hernia
Complication of cryptorchidism	Male infertility: irreparable damage and seminal tissue destined for irreversible atrophy Azoospermia Increased risk of developing testicular cancer not descended Inguinal hernia, epididymal torsion and testicular anomalies Testicular dissociation, agnesia and testicular atresia
Symptomatic picture of cryptorchidism	Cryptorchidism does not give a particular symptomatology and, generally, does not cause any pain to the patient When left untreated, advanced cryptorchidism could generate an abnormal mass, which in turn causes difficulty in walking
Diagnosis of cryptorchidism	Not particularly complicated diagnosis in cases of unilateral cryptorchidism without hypospadias: simple physical examination is sufficient Bilateral or unilateral forms of cryptorchidism with hypospadias: laboratory diagnostic tests are essential (LH, FSH, cariogramma and evaluation of pre / post stimulation testosterone with hCG)
Criptorchidism therapies	Medical therapy (administration of gonadotropins): restoration of the testicle inside the scrotal sac Surgical therapy (orchiopessia): the retracted testicle, or both, are surgically fixed inside the scrotal bursa Removal of the sick gonad: when therapeutic strategies are undertaken too late