++
For further information, see CMDT Part 26-30: Cryptorchism
++
One or both testes absent from the scrotum at birth
Must be distinguished from retractile testes, which require no treatment
++
Found in 1–2% of males after 1 year of age
Underlying hypogonadism, including hypogonadotropic hypogonadism, may be present
Infertility or subfertility occurs in up to 75% of men with bilateral cryptorchism and in 50% of men with unilateral cryptorchism
++
For a testis that is not palpable, it is important to locate the testis and bring it into the scrotum or prove its absence
About one-third on nonpalpable testes are located within the inguinal canal, one-third are intra-abdominal, and one-third absent
Ultrasound can detect an inguinal testis
If ultrasound is negative, MRI is performed to locate the testis
MRI is more reliable than ultrasound for locating cryptorchid testes
++
Human chorionic gonadotropin (hCG)
1500 units intramuscularly daily for 3 days, causes a significant rise in testosterone if the testes are present
Results in a testicular descent rate of about 25%
Surgical correction (orchiopexy)
For bilateral undescended testes,
For unilateral undescended testis
About 50% descend spontaneously
Early orchiopexy does not improve fertility, so it is usually delayed until after puberty
For intra-abdominal testes, orchiectomy after puberty is usually the best option