Cryptorchidism is characterized by absence of one or both testes from the scrotum. This is one of the more common types of birth defects seen in male infants.
The major and only sign of undescended testicles, is not feeling them in the scrotum. Studies have postulated the fact that, male boys with crytorchidism often suffer from psychological symptoms. It was seen that, when these boys underwent surgical procedures to correct the condition, a sudden boost in masculine characters and confidence occurred.
The following methods are carried out to diagnose the condition of cyrptorchidism :
Early initiation of treatment would help in preventing complications. If treatment is given during the first year of life, then there are less chances of onset of complications later. The following methods are employed for treating cryptorchidism:
In majority of the cases, the testes descend within the first few months of life. In cases, when they fail to do so, surgical procedures may have to be adopted. Surgery and medications employed to treat the condition is successful in most of the cases. However, in about 5% individuals, it is difficult to find testicles at the time of surgery. Such a type of condition is known as absent testis .
The exact cause of cyrptochidism is not clearly known. However, interplay of genetic and hormonal factors along with maternal health are known to influence the development of undescended testes. Research has also shown that changes in the activity of the nerves and various environmental factors are also known to play foul . In addition, several risk factors are also known to increase the likelihood of developing cryptorchidism. These include :
It has been estimated that, 30% of preterm infants develop undescended testes. The incidence of such a type of condition is found in only 3% of full term infants. The incidence of cryptorchidism decreases to 1% within 6 months to 1 year. The prevalence rate of cryptorchidism in the US is estimated to be 3.7% at birth and 1.1% from 1 year to adulthood.
Under normal conditions, the development of the testicles begins during conception. The SRY gene is the testes determining factor which if present favors the normal development of testes. At 3 to 5 weeks of gestation period, development of gonadal ridge occurs, which is followed by development of Sertoli cells. At 9 weeks gestation, the Leydig cells develop which secrete testosterone. Ultrasonography done before 28 weeks of gestation does not provide any evidence of testicular descent. The tests only provide knowledge about transabdominal movement to the internal side of inguinal ring .
During the last few months of fetal development, the testicles descend from tube like structure which is known as the inguinal canal into the scrotum. In condition of cryptorchidism, this process does not occur or is delayed .
It is not possible to prevent the development of cryptorchidism as formation of testicles begins during conception. Moreover, the exact cause of the condition is not known. However, certain risk factors can increase the risk of developing the same and in this regard; mothers are advised to avoid smoking and alcohol consumption during fetal development. They are also advised to stay away from second hand smoke and restrict themselves from exposure to environmental toxins and pesticides.
Cryptorchidism is more prevalent amongst infants who are born preterm. Full term infants are less likely to suffer from the same. By the time infants turn 9 months, the boy’s testicles descend naturally. In majority of the cases, only one testis is affected; however in 10% of cases, both testes fail to descend. Many a time undescended testis corrects by itself within the first few months of life. In cases, when this does not happen naturally, corrective surgical procedures may be required .
Definition: Cryptorchidism is a condition, wherein the testes do not descend naturally after birth of the child. It is a common birth defect which often gets naturally corrected by the time the child is 1 year old. The condition is a common phenomenon amongst preterm infants. Full term babies are very rarely affected by this condition.
Cause: The exact cause of cryptorchidism is unknown. However, several risk factors can increase the chances of developing the same. These include maternal exposure to environmental toxins, pesticides, second hand smoke and underlying disease conditions such as Down syndrome. Mothers who smoke or drink alcohol or have diabetes also put their babies at risk of developing undescended testes.
Symptoms: The major symptom of cryptorchidism is not feeling any testicle in its original position. Boys who experience this are also known to suffer from psychological symptoms.
Diagnosis: The condition is best diagnosed by a pediatric urologist. Several methods such as ultrasonography and imaging studies can also be performed to study the condition. However, none of these methods are cost effective. The method of laparoscopy is carried out detect the intrabdominal testicle.
Treatment: Surgery and medications forms the basis of treatment regime. Surgery to put the testes back into position is done either through open surgery or through laparoscopy. Hormone therapy is done by injecting human chorionic gonadotropin, which would cause the testicles to move to the scrotum. Prostheses may be implanted when either or both the testes are missing or they have been damaged during surgery.