Epidemiology

than 37 wk of gestation (10). It is likely that such testes are normal, and the delayed descent represents a continuum of a normal process that may extend beyond 40 wk after conception. In addition, there is a greater likelihood of descent in the 3 mo after birth if the maldescent is bilateral, suggesting a delay of the usual process, and if the scrotum is large and well developed at birth, suggesting greater stimulation by testosterone (11).

Although the estimated prevalence of undescended testes varies, the most consistent figures indicate that after 1 yr of age, 0.7% to 1% of males have one or two cryptorchid testes (4,11,16,17). These prevalence figures are similar to the 0.82% found in Nigerian schoolboys aged 5 to 13 yr, none of whom had been treated (18).

Although there have been reports suggesting a trend toward an increased incidence of cryptorchidism during recent decades (9), such trends have not been verified in all populations, and the prevalence varies considerably from different sampling regions (19,20). Taken together with evidence that cryptorchidism has increased in recent decades (9,11) are concerns that the incidence of other urogenital malformations, perhaps in association with cryptorchidism, is also rising and may result from chemicals, such as pesticides, with hormone-disrupting actions. For example, an increased risk (relative risk [RR] 1.67) of cryptorchidism was reported in the sons of women working in gardening but not in the sons of men working in farming or gardening (21). Data to date are inconclusive, necessitating further studies to document the rising incidence of cryptorchidism and any association with environmental agents.

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