Effects of the prenatal environment on cryptorchidism: A narrative review

Abstract

Cryptorchidism, the absence of testes from the scrotum, is the most common genital disorder in boys and a risk factor for reduced fertility and testicular cancer. The mechanism responsible for cryptorchidism involves two discrete stages: a transabdominal and an inguinoscrotal phase. These phases of testicular descent are regulated by the prenatal sex hormone environment, including levels of testosterone, insulin-like factor 3, and calcitonin gene-related peptide. Environmental endocrine disruptors, which are unfavorable environmental factors, may also affect testicular descent through prenatal sex hormones. This review examined the effects of environmental factors, particularly environmental endocrine disruptors, such as phthalates, organochlorine pesticides, diethylstilbestrol, bisphenol A, dioxins/dioxin-like compounds, and perfluoroalkyl substances, and parental lifestyles on the risk of cryptorchidism. Although some studies have shown that environmental endocrine disruptors can affect testicular descent by changing the hormonal environment during the prenatal period, no significant association has been established between exposure to environmental endocrine disruptors and the incidence of cryptorchidism. Therefore, the role played by environmental endocrine disruptor exposure (if any) in the pathogenesis of cryptorchidism remains unknown. Further studies are needed to examine these issues.

Minimally Invasive Surgery for Orchidopexy in Children with Cryptorchidism: Reducing the Need for an Inguinal Incision

“…Cryptorchidism is a common condition in boys. [14] The testes may continue to descend till six months of age after which the chances of spontaneous descent are very low. Children with undescended testis at six months of age should be operated before a year of age.…”

Utility of Laparoscopic Approach of Orchiopexy for Palpable Cryptorchidism: A Systematic Review and Meta-Analysis

“…After that period, the possibility of spontaneous testicular descent is extremely low. Recent recommendations suggest that optimal timing for orchiopexy, to avoid infertility and testicular cancer is between 6 and 18 months of age [1][2][3][4][5]26]. Although there are many controversies regarding hormonal therapy in boys with non-palpable cryptorchidism, a recent systematic review and meta-analysis showed that hormonal therapy can be effective in some cases and increase the success rate of complete testicular descent [27].…”

“…Undescended testes (UDT) or cryptorchidism is one of the most common surgical disorders of the inguino-scrotal region in children and is one of the common causes of male infertility [1]. Recent studies have demonstrated that about 10% of infertile men have a history of UDT and orchiopexy [2].…”

“…To identify the cases at high risk for infertility and who will require further treatment, blood sampling and testicular biopsy are required [4,5]. In addition to male infertility, as the most important consequence of cryptorchidism, boys with UDT are at a significantly higher risk of developing testicular tumors or testicular torsion, and are also more susceptible to testicular trauma compared to boys with normally positioned testicles [1,[5][6][7][8]. Taking all the above-mentioned points into account, the question of the optimal time when to do orchiopexy arises.…”

“…Taking all the above-mentioned points into account, the question of the optimal time when to do orchiopexy arises. Most of the recent clinical studies indicate that orchiopexy should be performed before the first year of life [1,4,6,9,10].…”