Cryptorchidism - what is the best timing and method of treatment?

Česká verzia

Authors: R. Kočvara
Authors place of work: 1. LF UK a VFN, Praha ; Urologická klinika
Published in the journal: Urol List 2007; 5(1): 30-33

Summary

Cryptorchidism covers (most often) retained, ectopic, missing and subsequently undescended testicle. In their first year of age, about 1% of boys still have a testicle undescended in the scrotum. The diagnosis requires physical bimanual examination - retracted testicle is best distinguished when patient is sitting cross-legged. Treatment of cryptorchidism may start as early as six months of age and the testicle should descend in scrotum by 1.5 years of age. When testicle is palpable, the golden standard treatment is orchidopexy, using, as a rule, the inguinal approach. For unpalpable testicle diagnostic laparoscopy is usually indicated: for intra-abdominal testicle a in one or two stages orchidopexy is performed (using laparoscopy or open approach). Unclear findings with revision of inguinal canal and dead ending internal spermatic vessels indicate anorchia. Distinctively hypoplastic testicle is indicated for orchidectomy. Hormonal treatment by HCG or LHRH analogue tends to lead to testicle descending only in low levels of retention. Recent trend has been neo- adjuvant or adjuvant hormonal treatment for operation which should improve future fertility.

Key words:
cryptorchidism, testicle retention, laparoscopy, orchidopexy, hormonal treatment

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