Cryptorchidism : Types, Causes & Treatment

Medically Reviewed by Dr Sravya, MBBS, MS 


Cryptorchidism is a condition associated with a risk of poor semen quality and a high risk of testicular germ cell tumors. Testicular hormones like androgens and insulin such as peptide-3 play an important role in the process of testicular descent from the intra-abdominal site into the scrotum in the fetal stage. In this condition, one or both testes are unable to descend into the scrotum.

Inguinal hernia, testicular trauma, low fertility/infertility, testicular cancer, and torsion are the associated issues. Effective diagnosis and treatment are essential for prevention of Cryptorchidism.

This condition with torsion is one of the specific types of testicular torsion. Unilateral or bilateral types of this condition is an abnormality in most cases and suggests that it is a complicated disorder arising due to interactions between genetic and environmental factors.

A condition of undescended testicles is very common in premature babies as compared to fully developed infants. An undescended testicle usually descends down on its own within some months after birth.

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In fully developed infants, the cause of cryptorchidism generally cannot be determined, it is a very common but sporadic, idiopathic congenital defect. It can be genetics combined with maternal and environmental factors that may disrupt hormones and physical changes that are responsible for testicular development and descent.

As testicular descent is a complex, multistage process, it is no surprise that no single common cause for this condition has been identified, as maldescent may be caused by derangements in any of the multiple endocrine and morphological pathways. Many authors think that androgen deficiency in utero, possibly related to abnormal placental or pituitary function, is the cause of cryptorchidism in some children.

Maternal smoking during pregnancy also has been identified as a likely cause of cryptorchidism in male offspring.

Possible underlying risk factors include:


A thought is developing that hormone treatment is not required for undescended testes and that orchidopexy should be done in the first year after birth. Surgery is the only option to save the testis. Both the time and the angle of torsion correlate with the recovery rate.

There are different approaches to performing orchiopexy. If the testis is not noticeable, a laparoscopic approach is followed; this can be a one-stage or two-stage surgery process depending on the indulgence of the spermatic cord and testicular vasculature.

If the testis is located in the inguinal canal, an inguinal orchiopexy is carried out. If the testis moves back and forth or at the top of the scrotum, the choice of surgery is the scrotal approach.

Generally, only one testis is fixated and then allowed to heal, so that in case of blood supply is stopped or infection develops, the patient has one testis remaining.

A. Scrotal Approach

B. Inguinal Approach- The most common approach

C. Laparoscopic Approach

Complications associated with orchiopexy2

Complications associated with any procedure are infection, bleeding, and scarring. In Orchiopexy along with these complications, there are several severe complications associated with it. These include: