UNDESCENDED TESTES
Incidence: In premature infants: 30%; In full term infants: 4%; At 3 months- 2%
Testis absent from scrotum after 3 months of age are unlikely to descent fully
Incompletely descended testis tends to atrophy as puberty approaches
More common on the right side(50%) and 20% cases are bilateral (cryptorchidism)
Secondary sexual characters are normal
Etiology
Gubernacular dysfunction
Lack of gonadotropins [HCG]
Lack of CGRP –calcitonin gene related peptide
Prune Belly syndrome
Familial
Complications
Torsion
Epididymo-orchitis(may mimic appendicitis)
Sterility (in bilateral cases, especially- intraabdominal testis)
Indirect Inguinal hernia
Increased liability to malignant disease
Atrophy
Treatment
Orchidopexy is usually done before 6 months of age
Orchidectomy: if the incompletely descended testis is atrophic, if patient is past puberty & other testis is normal
In bilateral cases, testis is passed into the opposite scrotum through an opening in the scrotal septum - Ombredanne’s operation
HCG or GnRH can be given when cryptorchidism is associated with hypogenitalism and obesity