Cryptorchidism Questions & Answers

1. [Guideline] Kolon TF, Herndon CD, Baker LA, Baskin LS, Baxter CG, Cheng EY, et al. Evaluation and treatment of cryptorchidism: AUA guideline. J Urol. 2014 Aug. 192 (2):337-45. [QxMD MEDLINE Link]. [Full Text].

2. Heyns CF, Hutson JM. Historical review of theories on testicular descent. J Urol. 1995 Mar. 153(3 Pt 1):754-67. [QxMD MEDLINE Link].

3. Kübarsepp V, Varik K, Varendi H, Antson A, Veinla M, Nellis G, et al. Prevalence of congenital cryptorchidism in Estonia. Andrology. 2022 Feb. 10 (2):303-309. [QxMD MEDLINE Link].

4. Elert A, Jahn K, Heidenreich A, et al. [The familial undescended testis]. Klin Padiatr. 2003 Jan-Feb. 215(1):40-5. [QxMD MEDLINE Link].

5. Cheng Z, Wang M, Xu C, Pei Y, Liu JC, Huang H, et al. Mutational analysis of HOXA10 gene in Chinese patients with cryptorchidism. Andrologia. 2017 Feb. 49 (1):[QxMD MEDLINE Link].

6. Kolon TF, Wiener JS, Lewitton M, et al. Analysis of homeobox gene HOXA10 mutations in cryptorchidism. J Urol. 1999 Jan. 161(1):275-80. [QxMD MEDLINE Link].

7. Fantasia J, Aidlen J, Lathrop W, Ellsworth P. Undescended Testes: A Clinical and Surgical Review. Urol Nurs. 2015 May-Jun. 35 (3):117-26. [QxMD MEDLINE Link].

8. Hutson JM, Donahoe PK. The hormonal control of testicular descent. Endocr Rev. 1986 Aug. 7(3):270-83. [QxMD MEDLINE Link].

9. Shono T, Ramm-Anderson S, Goh DW, et al. The effect of flutamide on testicular descent in rats examined by scanning electron microscopy. J Pediatr Surg. 1994 Jun. 29(6):839-44. [QxMD MEDLINE Link].

10. Ahmed SF, Cheng A, Dovey L, et al. Phenotypic features, androgen receptor binding, and mutational analysis in 278 clinical cases reported as androgen insensitivity syndrome. J Clin Endocrinol Metab. 2000 Feb. 85(2):658-65. [QxMD MEDLINE Link].

11. Hauser R, Skakkebaek NE, Hass U, Toppari J, Juul A, Andersson AM, et al. Male reproductive disorders, diseases, and costs of exposure to endocrine-disrupting chemicals in the European Union. J Clin Endocrinol Metab. 2015 Apr. 100 (4):1267-77. [QxMD MEDLINE Link]. [Full Text].

12. Yamanaka J, Baker M, Metcalfe S, et al. Serum levels of Mullerian inhibiting substance in boys with cryptorchidism. J Pediatr Surg. 1991 May. 26(5):621-3. [QxMD MEDLINE Link].

13. Hutson JM, Watts LM. Both gonadotropin and testosterone fail to reverse estrogen-induced cryptorchidism in fetal mice: Further evidence for nonandrogenic control of testicular descent in the fetus. Pediatr Surg Int. 1990. 5:13-18.

14. Fentener van Vlissingen JM, Koch CA, Delpech B, et al. Growth and differentiation of the gubernaculum testis during testicular descent in the pig: changes in the extracellular matrix, DNA content, and hyaluronidase, beta-glucuronidase, and beta-N-acetylglucosaminidase activities. J Urol. 1989 Sep. 142(3):837-45. [QxMD MEDLINE Link].

15. Wensing CJ. The embryology of testicular descent. Horm Res. 1988. 30(4-5):144-52. [QxMD MEDLINE Link].

16. Backhouse KM. The natural history of testicular descent and maldescent. Proc R Soc Med. 1966 Apr. 59(4):357-60. [QxMD MEDLINE Link].

17. Hutson JM, Beasley SW. The mechanisms of testicular descent. Aust Paediatr J. 1987 Aug. 23(4):215-6. [QxMD MEDLINE Link].

18. Heyns CF. The gubernaculum during testicular descent in the human fetus. J Anat. 1987 Aug. 153:93-112. [QxMD MEDLINE Link].

19. Levard G, Laberge JM. The fate of undescended testes in patients with gastroschisis. Eur J Pediatr Surg. 1997 Jun. 7(3):163-5. [QxMD MEDLINE Link].

20. Koivusalo A, Taskinen S, Rintala RJ. Cryptorchidism in boys with congenital abdominal wall defects. Pediatr Surg Int. 1998 Mar. 13(2-3):143-5. [QxMD MEDLINE Link].

21. Frey HL, Peng S, Rajfer J. Synergy of abdominal pressure and androgens in testicular descent. Biol Reprod. 1983 Dec. 29(5):1233-9. [QxMD MEDLINE Link].

22. Hadziselimovic F, Duckett JW, Snyder HM 3rd, et al. Omphalocele, cryptorchidism, and brain malformations. J Pediatr Surg. 1987 Sep. 22(9):854-6. [QxMD MEDLINE Link].

23. Elder JS. Epididymal anomalies associated with hydrocele/hernia and cryptorchidism: implications regarding testicular descent. J Urol. 1992 Aug. 148(2 Pt 2):624-6. [QxMD MEDLINE Link].

24. Murase K, Murase J, Machidori K, Mizuno K, Hayashi Y, Kohri K. Nationwide Increase in Cryptorchidism After the Fukushima Nuclear Accident. Urology. 2018 May 8. [QxMD MEDLINE Link].

25. Cisek LJ, Peters CA, Atala A, et al. Current findings in diagnostic laparoscopic evaluation of the nonpalpable testis. J Urol. 1998 Sep. 160(3 Pt 2):1145-9; discussion 1150. [QxMD MEDLINE Link].

26. Rabinowitz R, Hulbert WC Jr. Late presentation of cryptorchidism: the etiology of testicular re-ascent. J Urol. 1997 May. 157(5):1892-4. [QxMD MEDLINE Link].

27. Scorer CG, Farrington GH. Congenital Deformities of the Testis and Epididymis, New York, Appleton-Century-Crofts. 1971.

28. Cendron M, Huff DS, Keating MA, et al. Anatomical, morphological and volumetric analysis: a review of 759 cases of testicular maldescent. J Urol. 1993 Mar. 149(3):570-3. [QxMD MEDLINE Link].

29. Cortes D, Thorup JM, Visfeldt J. Cryptorchidism: aspects of fertility and neoplasms. A study including data of 1,335 consecutive boys who underwent testicular biopsy simultaneously with surgery for cryptorchidism. Horm Res. 2001. 55(1):21-7. [QxMD MEDLINE Link].

30. Hildorf S, Clasen-Linde E, Cortes D, Fossum M, Thorup J. Fertility Potential is Compromised in 20% to 25% of Boys with Nonsyndromic Cryptorchidism despite Orchiopexy within the First Year of Life. J Urol. 2020 Apr. 203 (4):832-840. [QxMD MEDLINE Link].

31. Huff DS, Fenig DM, Canning DA, et al. Abnormal germ cell development in cryptorchidism. Horm Res. 2001. 55(1):11-7. [QxMD MEDLINE Link].

32. Hadziselimovic F, Herzog B. The importance of both an early orchidopexy and germ cell maturation for fertility. Lancet. 2001 Oct 6. 358(9288):1156-7. [QxMD MEDLINE Link].

33. Lee PA, O'Leary LA, Songer NJ, et al. Paternity after cryptorchidism: lack of correlation with age at orchidopexy. Br J Urol. 1995 Jun. 75(6):704-7. [QxMD MEDLINE Link].

34. Cendron M, Keating MA, Huff DS, et al. Cryptorchidism, orchiopexy and infertility: a critical long-term retrospective analysis. J Urol. 1989 Aug. 142(2 Pt 2):559-62; discussion 572. [QxMD MEDLINE Link].

35. Coughlin MT, Bellinger MF, LaPorte RE, et al. Testicular suture: a significant risk factor for infertility among formerly cryptorchid men. J Pediatr Surg. 1998 Dec. 33(12):1790-3. [QxMD MEDLINE Link].

36. Farrer JH, Walker AH, Rajfer J. Management of the postpubertal cryptorchid testis: a statistical review. J Urol. 1985 Dec. 134(6):1071-6. [QxMD MEDLINE Link].

37. Abratt RP, Reddi VB, Sarembock LA. Testicular cancer and cryptorchidism. Br J Urol. 1992 Dec. 70(6):656-9. [QxMD MEDLINE Link].

38. Tuazon E, Banks K, Koh CJ, et al. Re: Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. J Urol. 2008 Aug. 180(2):783-4; author reply 784-5. [QxMD MEDLINE Link].

39. Walsh TJ, Dall'Era MA, Croughan MS, et al. Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. J Urol. 2007 Oct. 178(4 Pt 1):1440-6; discussion 1446. [QxMD MEDLINE Link].

40. Campbell HE. Incidence of malignant growth of the undescended testicle: A critical and statistical study. Arch Surg. 1942. 44:353.

41. Martin DC, Menck HR. The undescended testis: management after puberty. J Urol. 1975 Jul. 114(1):77-9. [QxMD MEDLINE Link].

42. Martin DC. Germinal cell tumors of the testis after orchiopexy. J Urol. 1979 Apr. 121(4):422-4. [QxMD MEDLINE Link].

43. Kargl S, Haid B. Torsion of an undescended testis - A surgical pediatric emergency. J Pediatr Surg. 2020 Apr. 55 (4):660-664. [QxMD MEDLINE Link].

44. Pettersson A, Richiardi L, Nordenskjold A, et al. Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med. 2007 May 3. 356(18):1835-41. [QxMD MEDLINE Link].

45. Rogers E, Teahan S, Gallagher H, et al. The role of orchiectomy in the management of postpubertal cryptorchidism. J Urol. 1998 Mar. 159(3):851-4. [QxMD MEDLINE Link].

46. Hrebinko RL, Bellinger MF. The limited role of imaging techniques in managing children with undescended testes. J Urol. 1993 Aug. 150(2 Pt 1):458-60. [QxMD MEDLINE Link].

47. Shoukry M, Pojak K, Choudhry MS. Cryptorchidism and the value of ultrasonography. Ann R Coll Surg Engl. 2015 Jan. 97 (1):56-8. [QxMD MEDLINE Link].

48. Tasian GE, Copp HL, Baskin LS. Diagnostic imaging in cryptorchidism: utility, indications, and effectiveness. J Pediatr Surg. 2011 Dec. 46(12):2406-13. [QxMD MEDLINE Link].

49. Rajfer J, Handelsman DJ, Swerdloff RS, et al. Hormonal therapy of cryptorchidism. A randomized, double-blind study comparing human chorionic gonadotropin and gonadotropin-releasing hormone. N Engl J Med. 1986 Feb 20. 314(8):466-70. [QxMD MEDLINE Link].

50. De Muinck Keizer-Schrama SM, Hazebroek FW, Drop SL, et al. LH-RH nasal spray treatment for cryptorchidism. A double-blind, placebo-controlled study. Eur J Pediatr. 1987. 146 Suppl 2:S35-7. [QxMD MEDLINE Link].

51. Fedder J, Boesen M. Effect of a combined GnRH/hCG therapy in boys with undescended testicles: evaluated in relation to testicular localization within the first week after birth. Arch Androl. 1998 May-Jun. 40(3):181-6. [QxMD MEDLINE Link].

52. Wei Y, Wang Y, Tang X, Liu B, Shen L, Long C, et al. Efficacy and safety of human chorionic gonadotropin for treatment of cryptorchidism: A meta-analysis of randomised controlled trials. J Paediatr Child Health. 2018 Apr 14. [QxMD MEDLINE Link].

53. Hesse V, Fischer G. Three injections of human chorionic gonadotropin are as effective as ten injections in the treatment of cryptorchidism. Horm Res. 1988. 30(4-5):193-7. [QxMD MEDLINE Link].

54. Lala R, Matarazzo P, Chiabotto P, et al. Combined therapy with LHRH and HCG in cryptorchid infants. Eur J Pediatr. 1993. 152 Suppl 2:S31-3. [QxMD MEDLINE Link].

55. Bica DT, Hadziselimovic F. The behavior of epididymis, processus vaginalis and testicular descent in cryptorchid boys treated with buserelin. Eur J Pediatr. 1993. 152 Suppl 2:S38-42. [QxMD MEDLINE Link].

56. Hadziselimovic F, Girard J, Herzog B, et al. Hormonal treatment of cryptorchidism. Horm Res. 1982. 16(3):188-92. [QxMD MEDLINE Link].

57. Chua ME, Mendoza JS, Gaston MJ, Luna SL Jr, Morales ML Jr. Hormonal therapy using gonadotropin releasing hormone for improvement of fertility index among children with cryptorchidism: a meta-analysis and systematic review. J Pediatr Surg. 2014 Nov. 49 (11):1659-67. [QxMD MEDLINE Link].

58. [Guideline] European Association of Urology (EAU). Paediatric Urology Guidelines. uroweb.org. Available at https://uroweb.org/guidelines/paediatric-urology. 2022; Accessed: October 6, 2022.

59. Sfoungaris D, Mouravas V, Petropoulos A, Filippopoulos A. Prentiss orchiopexy applied in younger age group. J Pediatr Urol. 2011 Nov 1. [QxMD MEDLINE Link].

60. Docimo SG. The results of surgical therapy for cryptorchidism: a literature review and analysis. J Urol. 1995 Sep. 154(3):1148-52. [QxMD MEDLINE Link].

61. Feyles F, Peiretti V, Mussa A, Manenti M, Canavese F, Cortese MG, et al. Improved sperm count and motility in young men surgically treated for cryptorchidism in the first year of life. Eur J Pediatr Surg. 2014 Oct. 24(5):376-80. [QxMD MEDLINE Link].

62. Allin BSR, Dumann E, Fawkner-Corbett D, Kwok C, Skerritt C, Paediatric Surgery Trainees Research Network. Systematic review and meta-analysis comparing outcomes following orchidopexy for cryptorchidism before or after 1 year of age. BJS Open. 2018 Feb. 2 (1):1-12. [QxMD MEDLINE Link]. [Full Text].

63. Bellinger MF, Abromowitz H, Brantley S, et al. Orchiopexy: an experimental study of the effect of surgical technique on testicular histology. J Urol. 1989 Aug. 142(2 Pt 2):553-5; discussion 572. [QxMD MEDLINE Link].

64. Dixon TK, Ritchey ML, Boykin W, et al. Transparenchymal suture fixation and testicular histology in a prepubertal rat model. J Urol. 1993 May. 149(5):1116-8. [QxMD MEDLINE Link].

65. Jarow JP. Clinical significance of intratesticular arterial anatomy. J Urol. 1991 Apr. 145(4):777-9. [QxMD MEDLINE Link].

66. Storm D, Redden T, Aguiar M, et al. Histologic evaluation of the testicular remnant associated with the vanishing testes syndrome: is surgical management necessary?. Urology. 2007 Dec. 70(6):1204-6. [QxMD MEDLINE Link].

67. Jordan GH, Robey EL, Winslow BH:. Laparoendoscopic surgical management of the abdominal/transinguinal undescended testicle. J Endourol. 1992. 6:159.

68. Shehata S, Shalaby R, Ismail M, Abouheba M, Elrouby A. Staged laparoscopic traction-orchiopexy for intraabdominal testis (Shehata technique): Stretching the limits for preservation of testicular vasculature. J Pediatr Surg. 2016 Feb. 51 (2):211-5. [QxMD MEDLINE Link].

69. Alzahem A. Laparoscopy-assisted orchiopexy versus laparoscopic two-stage fowler stephens orchiopexy for nonpalpable testes: Comparative study. Urol Ann. 2013 Apr. 5 (2):110-4. [QxMD MEDLINE Link]. [Full Text].

70. Chung JM, Lee SD. Individualized Treatment Guidelines for Postpubertal Cryptorchidism. World J Mens Health. 2015 Dec. 33 (3):161-6. [QxMD MEDLINE Link]. [Full Text].

71. Giwercman A, Dezuyei N, Lundwall A, et al. Testicular cancer and molecular genetics. Andrologia. 2005 Dec. 37(6):224-5. [QxMD MEDLINE Link].

72. Lenz S, Skakkebaek NE, Hertel NT. Abnormal ultrasonic pattern in contralateral testes in patients with unilateral testicular cancer. World J Urol. 1996. 14 Suppl 1:S55-8. [QxMD MEDLINE Link].

73. Hadziselimovic F, Herzog B. Treatment with a luteinizing hormone-releasing hormone analogue after successful orchiopexy markedly improves the chance of fertility later in life. J Urol. 1997 Sep. 158(3 Pt 2):1193-5. [QxMD MEDLINE Link].

74. Schwentner C, Oswald J, Kreczy A, et al. Neoadjuvant gonadotropin-releasing hormone therapy before surgery may improve the fertility index in undescended testes: a prospective randomized trial. J Urol. 2005 Mar. 173(3):974-7. [QxMD MEDLINE Link].

75. Kawada T, Yamanaka H, Hasegawa Y. Decreased immunoreactive inhibin and increased FSH levels in cryptorchidism after orchidopexy. Endocr J. 1995 Aug. 42(4):577-80. [QxMD MEDLINE Link].

76. Whitaker RH. Management of the undescended testis. Br J Hosp Med. 1970. 4:25.

Joel M Sumfest, MD Director of Pediatric Urology, Janet Weis Children's Hospital, Geisinger Medical Center; Vice Chairman, Department of Urology, Geisinger Medical Center

Joel M Sumfest, MD is a member of the following medical societies: American Academy of Pediatrics, American Urological Association, Societies for Pediatric Urology, Society for Fetal Urology

Disclosure: Nothing to disclose.

Daniel B Rukstalis, MD Professor of Urology, Wake Forest Baptist Health System, Wake Forest University School of Medicine

Daniel B Rukstalis, MD is a member of the following medical societies: American Association for the Advancement of Science, American Urological Association

Disclosure: Nothing to disclose.

Thomas F Kolon, MD, MS Associate Professor of Urology, Division of Pediatric Urology, The Children's Hospital of Philadelphia

Thomas F Kolon, MD, MS is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Urological Association, Societies for Pediatric Urology, Society of University Urologists, Society for Fetal Urology, Society of Urology Chairpersons and Program Directors, Society for the Study of Male Reproduction

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Edward David Kim, MD, FACS Professor of Urology, Department of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American Society for Reproductive Medicine, American Urological Association, Sexual Medicine Society of North America, Society for Male Reproduction and Urology, Society for the Study of Male Reproduction, Tennessee Medical Association

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Endo, Antares.

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