What is Cryptorchidism?

Cryptorchidism is a medical condition in which one or both testicles fail to descend into the scrotum by the time a baby is born. In most cases, the condition naturally corrects itself within the first year of life. The testes of males who are born prematurely and those who have a familial history of cryptorchidism, however, may not descend without medical intervention. The most common treatments for undescended testicles include hormone therapy and a surgical procedure to manually bring the testes into their correct position.

Healthy infants typically have fully descended testicles at birth. If a baby is born prematurely, the testes may not have the chance to fully develop and descend. One or both testes can be halted in their descent anywhere from their origin in the abdomen to the base of the scrotum. For babies that have the condition despite being carried to term, the cause may be difficult to identify. Males whose brothers or fathers have suffered from cryptorchidism are more likely to have the condition. Abnormally low levels of the hormones testosterone and human chorionic gonadotropin (HGC) can also prevent the testes from completely descending.

Left untreated, cryptorchidism can lead to a number of health problems. The most common complication of undescended testicles in post-pubescent males is infertility. The testes are prevented from completing spermatogenesis, the process by which sperm cells are produced and matured. In addition, the risk of developing testicular cancer is up to 40-times higher for males with one or both testicles undescended.

A pediatrician can usually diagnose cryptorchidism by physically examining the scrotum and lower abdomen. The doctor may conduct ultrasounds or x-rays to determine the exact location of the undescended testes and take blood samples to check for low levels of HGC or testosterone. If the doctor believes that the testes are unlikely to descend on their own, he will discuss treatment options with the infant's parents or caregivers.

Hormone replacement therapy can be effective if the cause of cryptorchidism is discovered to be deficiencies in testosterone and HGC. In other cases, however, surgery is usually the preferred treatment option. A procedure known as an orchiopexy can be performed on infants over the age of six months, and has a high success rate. The surgeon makes a small incision in the scrotum and manipulates tiny surgical tools to find and pull down the testes. Following surgery, regular checkups usually are needed to confirm the success of the procedure and ensure that there is no permanent structural damage to the reproductive system.