Early orchiopexy to prevent germ cell loss during infancy in congenital cryptorchidism

Abstract

Cryptorchidism is a problematic topic, beginning with its meaning. Although, by etymology, it refers to “hidden testes,” the term cryptorchidism has been widely used to describe testes that are not in their normal position in the scrotum. The strictest terminology distinguishes between bilaterally absent testes (“anorchia”), the absence of one testis (“monorchia”), the existence of one or both testes in a position along (“undescended or maldescended testes”) or outside (“ectopic testes”) the normal pathway of descent from the abdominal cavity, and their spontaneously changing position back and forth from the scrotum to the inguinal canal (“retractile testes”). Although these rigorous definitions can only be applied after a definite diagnosis is made, most physicians use the terms cryptorchidism and ectopic or undescended testes to refer loosely to the absence of the testes in the scrotum, even before ascertaining their existence in the case of nonpalpable gonads. It is therefore not surprising that major controversies remain surrounding the epidemiology, the pathogenesis, the diagnosis, the long-term consequences, and the treatment of cryptorchidism. Moreover, conclusions based on inadequate study design have added to the confusion.