Cryptorchidism, the condition in which one or both testes are not descended fully into the scrotum, is one of the most frequent developmental anomalies of the human male. Although there is spontaneous descent in the first few months of life in many males born with this condition, the prevalence thereafter is about 1%. Genetic direction of testicular descent is only poorly understood. There are multiple etiologies of cryp-torchidism, both anatomic and hormonal, with some testes having the potential for normal function.
Germ cells in the undescended testis fail to undergo normal differentiation from early infancy; hence, the recommendation for treatment by 1 yr of age. Frequently, men with undescended testes have impaired sperm production and decreased inhibin-B and elevated FSH levels during adulthood. Only a small portion of men who had unilateral cryptorchidism are infertile based on paternity, whereas nearly half of men with previous bilateral cryptorchidsm are infertile. The risk of developing testicular tumors, primarily of germ cell origin, is increased substantially particularly in the bilateral group and those not corrected before puberty.
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