Cryptorchidism is a relatively common condition, occurring in up to 9% in full-term infants and can occur in as many as 30% in premature neonates. About 80% of undescended testes (UDT) migrate into the scrotum by 3 to 6 months of age. UDT can be either unilateral or bilateral (10%). Around 80% are palpable, and 90% of those are palpated in the inguinal canal. More than 90% of patients have a concomitant patent processus vaginalis.
Multiple risk factors contribute to the development of UDT. These include twinning, low birth weight, a birth weight that does not correlate appropriately with gestational age, and prematurity. Of these, prematurity is the most significant.
Types:
True undescended testis - The testis is located anywhere in the natural path of descent.
Retroperitoneal, intrabdominal, in the inguinal canal, at the superior aspect of the scrotum
Ectopic undescended testis - testis is not anywhere along the natural path of descent.
In the femoral canal
The opposite scrotum
Perineum
In the femoral canal
Hypoplastic - underdeveloped testis
Dysgenetic - derangement of seminiferous tubules and function of testes
Vanished - thought to be due to intrauterine testicular torsion in late gestation.
It is important to note only 20 to 40% of non-palpable testes are truly absent at the time of surgery.
Ascent - a testis that was in the scrotum but has since returned to the inguinal canal
Retractile - A testis that moves in and out of the scrotum
Acquired - failure of the spermatic cord to grow in proportion to body growth
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