Open controversies on the treatment of undescended testis: An update

Abstract

Cryptorchidism is a common congenital malformation in pediatric urology. Although there have been many studies on the etiology of the disease, it has not been fully clarified, and while its diagnostic and treatment models have gradually approached standardization and systematization, some controversies regarding treatment remain. Additionally, although ultrasound is a non-invasive examination without ionizing radiation, its role in the evaluation of cryptorchidism remains controversial. The main basis for treating cryptorchidism is orchidopexy, and the main view on treatment age is that treatment should be performed between 6 and 12 months after birth, but no more than 18 months after birth. The view on hormone therapy is still controversial because most scholars believe that early surgery is the key to treatment. There are many surgical treatment methods for cryptorchidism, including traditional open surgery and laparoscopic surgery, which provide satisfactory results. In conclusion, the treatment of undescended testis (UDT) had been largely standardized, apart from the treatment of high intra-abdominal testis (IAT), which remains a matter of debate.

Laparoscopic approach of inguinal hernia associated with adult cryptorchidism: case series and literature review

“…Hernia associated with cryptorchidism has been identified in many cases during laparoscopy or MRI, but clinically, it can be missed [ 16 ]. Ultrasonography, MRI, and CT are useful for identifying and locating the undescended testis.…”

Retrocecal Ascending Appendix Attached to the Hepatic Flexure and Right Intra-abdominal Testis Identified During Open Appendicectomy: A Case Report

“…Undescended testes (UDT), or cryptorchidism, is a common congenital disorder that is divided into palpable or non-palpable testes (NPT) [ 11 ]. It is also a risk factor for future malignancy, infertility, and other adverse outcomes [ 12 ].…”

“…Again, having never been to a physician for examination, our patient presented late with this disorder, which warranted the excision of the testis. If detected early, surgical intervention by the age of 18 months can prevent testicular degenerative changes and reduce the chances of conversion to malignancy [ 11 ].…”

Impact of Men with Undescended Testis on Fertility and Hormonal Function Promoting Hypogonadism

“…Various old studies have documented a reduction in fertility rates among UDT patients using paternity rate criteria. 27 Reduced paternity rates are more frequent in men with comparing men with bilateral UDT to those with unilateral UDT and men without UDT. 28 Men with bilateral UDT are 3.5 times more frequent of being infertile than unilateral UDT men and six times riskier than men without UDT.…”

“…28 Men with bilateral UDT are 3.5 times more frequent of being infertile than unilateral UDT men and six times riskier than men without UDT. 5,27 The occurrence of infertility in UDT is associated with the failure to transform gonocytes to Ad spermatogonia. 29 Early in life, the conversion of neonatal gonocytes into Ad spermatogonia is impeded, and this causes a deficiency of germ cells for post-pubertal spermatogenesis and infertility.…”