Undescended testes (cryptorchidism) in children: Clinical features and evaluation
- Christopher S Cooper, MD, FACS, FAAP
Christopher S Cooper, MD, FACS, FAAP
- Professor of Urology
- University of Iowa College of Medicine
- Steven G Docimo, MD
Steven G Docimo, MD
- Professor of Urology
- University of Pittsburgh School of Medicine
- Section Editors
- Jan E Drutz, MD
Jan E Drutz, MD
- Section Editor — General Pediatrics
- Professor of Pediatrics
- Baylor College of Medicine
- Laurence S Baskin, MD, FAAP
Laurence S Baskin, MD, FAAP
- Section Editor — Pediatric Urology
- Frank Hinman, Jr., MD, Distinguished Professorship in Pediatric Urology
- Chief Pediatric Urology
- Professor of Urology and Pediatrics
- UCSF Benioff Children's Hospital
- Mitchell E Geffner, MD
Mitchell E Geffner, MD
- Section Editor — Pediatric Endocrinology
- Professor of Pediatrics
- Keck School of Medicine, University of Southern California
Cryptorchidism is the most common congenital abnormality of the genitourinary tract . Most cryptorchid testes are undescended, but some are absent (due to agenesis or atrophy).
The clinical features and evaluation of cryptorchidism will be discussed here. The management of undescended testes is discussed separately. (See "Undescended testes (cryptorchidism) in children: Overview of management".)
Cryptorchidism – Cryptorchidism by definition suggests a hidden testis: a testis that is not within the scrotum and does not descend spontaneously into the scrotum by four months of age (or corrected age for premature infants) (picture 1). Cryptorchid testes may be absent or undescended.
Absent testis – An absent testis may be due to agenesis or atrophy secondary to intrauterine vascular compromise (eg, prenatal testicular torsion), also known as the "vanishing testis syndrome" or testicular regression syndrome . Boys who have bilaterally absent testes have anorchia. (See "Neonatal testicular torsion", section on 'Prenatal'.)
Undescended testes – True undescended testes have stopped short along their normal path of descent into the scrotum (figure 1). They may remain in the abdominal cavity (picture 2) or they may be palpable in the inguinal canal (intracanalicular) or just outside the external ring (suprascrotal (picture 3)) .
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- EPIDEMIOLOGY AND RISK FACTORS
- ASSOCIATED CONDITIONS
- CLINICAL FEATURES
- COMPLICATIONS AND SEQUELAE
- - General examination
- - Examination of the testes and genitalia
- DIAGNOSTIC APPROACH
- Palpable cryptorchid testes
- Unilateral nonpalpable testis
- - Unilateral nonpalpable testis and hypospadias
- Bilateral nonpalpable testes
- - Newborn
- - Older child
- INDICATIONS FOR REFERRAL
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS