Putting the pieces together: cryptorchidism – do we know everything?

Abstract

Cryptorchidism is one of the most common birth defects in male children, and it has a potential impact on future health. It is the best-characterized risk factor for reduced fertility and testicular cancer. However, the etiology of cryptorchidism remains largely unknown. In the literature, we find different opinions and theories on this topic. Probably, the etiology is multifactorial, and hormonal, genetic and environmental factors may regulate testicular development and descent from intra-abdominal location into the bottom of the scrotum. The descent of the testis is a complex, two-stage process. A critical role in testicular descent has been attributed to androgens, insulin-like hormone 3 (insl3) and anti-Müllerian hormone. It is believed that interaction between Leydig and Sertoli cells may cause impaired spermatogenesis. Based on recent knowledge of germ cell development, it is believed that the best treatment for undescended testis is orchiopexy between 6th and 12th month of life. Long follow-up studies are needed to focus on the effect of this recommendation.

The Effectiveness of hCG and LHRH in Boys with Cryptorchidism: A Meta-Analysis of Randomized Controlled Trials

“…The previous study suggested lower initial location of the testicle might be associated with a greater likelihood of success for hormonal treatment, even the success rate got to 55-60 % [6,15,17]. And hormonal treatment was possibly more effective on bilateral cryptorchidism than unilateral cryptorchidism in our study and previous reports [19,28]. So the future studies of hormonal treatment should focus on more detailed indications.…”

“…2); Pain in inguinal region (1); Growth of penis or testis(3) Hemorrhinia and growth of penis(1)Esposito C (2003)[19] Frequent erections; Aggressive behavior; Development of pubic hair; Pain at the injection site or in the inguinal regionNosideeffectsZhao HT (2010)[19] Nosideeffects Growth of penis or testis(28) …”

Post‐fertilization effect of bilateral primary testicular damage induced by unilateral cryptorchidism in the rat model

“…There have also been studies attributing even higher prevalence of cryptorchidism at birth such as 5.9% in the UK (Acerini et al ., ) and 9.0% in Denmark (Boisen et al ., ). In fact, although it is often considered a mild malformation, it represents the best‐defined risk factor for reduced fertility and testicular cancer (Komarowska et al ., ). Furthermore, some reports have highlighted a significant increase in the prevalence of cryptorchidism over the last few decades (Foresta et al ., ).…”

Is testicular torsion a real problem in pediatric patients with cryptorchidism?

“…Cryptorchidism is the most common genital disorder in males (3), and generally should be diagnosed and treated in the neonatal period (4). The consequences of an undescended testicle are higher risk of testicular cancer (5) and impaired fertility (6).…”