Cryptorchidism

Question 1

Definition

Answer 1

Cryptorchidism is the most common genital problem encountered in pediatrics. Cryptorchidism literally means hidden or obscure testis and generally refers to an undescended or maldescended testis.

Question 2

Incidence

Answer 2

🥲2-5% of term males
🥲 most of these descend spontaneously by 6 mo of age
🥲 1% of males do not spontaneously descend
🥲Suspect in prematurity

Question 3

patho - physiology

Answer 3

😗Idiopathic
😗Descent is mediated by descendin which is created in response to testosterone
😗Descent usually begins at 28 wk

Question 4

Clinical picture

Answer 4

😟 Palpable testicle within inguinal canal or testicle which can be milked down into the scrotum (called retractile testis)
😟Occasionally no palpable testis as it is intra-abdominal
🤨Consider other congenital abnormalities

Question 5

Physical Exam

Answer 5

Scrotal asymmetry Bi-annual testicular exam with palpation Distinguish truly undescended testis from retractile testis (which is “high” testis due to hyperactive cremasteric muscles)

Question 6

TX

Answer 6

🤗hCG to stimulate testosterone production and descent

🌚Orchidopexy – especially if undescended by age 6 mo-2 yr