Prepubertal Cryptorchidism

Prepubertal Cryptorchidism General Information

During the development of a male baby, the testes begin to grow in the abdomen and as gestation progresses, they migrate into the scrotum. This process usually occurs during the seventh or eighth month of gestation. Some males’ testes (one or both) fail to descent into the scrotum; these persons suffer from a condition called Prepubertal Cryptorchidism. Sometimes, if there is only one testicle that did not descend, the respective testicle may resolve on its own. If self-correcting does not occur, surgery may be needed. This type of surgery is performed in infancy and it is called orchiopexy. The intervention is needed to move and then to anchor the undescendent testicle into its right position inside the scrotum.

About 5% of full-term and about 20 %of the premature baby boys are born suffering from Prepubertal Cryptorchidism. The undescendend testis is considered more a birth defect of male genital organs. If a male baby develops normally during the period of gestation, he can still present the risk of developing this type of medical condition in the first years of life, usually before puberty. A testicle that is not in the right scrotal position can be found: in the inguinal canal, anywhere along the descent path (just below the kidney, to the inguinal ring) or outside the path of descent - inguinal canal. Also, a testis can be found vanished, dysgenetic (severely abnormal) or hypoplastic (undeveloped). Prepubertal Cryptorchidism has negative effects on the respective patient: reduced fertility, affective disorders, psychological disorders and increased risk of developing testicular tumors.

Prepubertal Cryptorchidism Symptoms

Prepubertal Cryptorchidism is a medical condition that interferes seriously in the patient’s quality of life. As any other medical disorder, this one too has some specific signs and symptoms that can be immediately observed. Most manifestations of this medical condition are not painful, although the disease itself can lead to the appearance of several changes in the mood and behavior of the respective boy. Having an undescended testicle can be easily noticed. A mother of a male baby who may suffer from Prepubertal Cryptorchidism can observe that his testes or testicles have not completely descent into the scrotum. This means that his testes may still be present in the passageway between the scrotum and the abdominal wall (partway down the inguinal canal) or in the abdominal region. In some rarer and sad cases, the testicles may have never existed. You must have in mind that Prepubertal Cryptorchidism symptoms usually refer to certain signs that are already known by the patient, although the presence of other clinical manifestations that can only be noticed by a professional can be noticed as well. A patient diagnosed with this medical disorder may also suffer from associated abnormalities that can include: hypospadias, abnormal epididymis, prune belly, omphalocele, gastroschisis (defects of the abdominal wall), mental retardation, cerebral palsy and Wilm’s tumor. The transport of the sperm is also affected in only 6-7 % of the cases. Precocious puberty can be a cause that leads to the appearance of this male genital disorder. A twisting of the blood that supplies the gonads on the gestation period can also be a cause.

Prepubertal Cryptorchidism Treatment

Undescended testicles can be easily observed shortly after birth of the male baby. It is important to seek medical advice as soon as you notice this birth defect of your child. The chances that the undescended testicle (or testes) recovers increase if you talk with your baby’s health care provider after you observe that your newborn’s testes (or testicle) have not go down into the scrotum. Prepubertal Cryptorchidism is a serious medical condition that affects the male possibility to reproduce. A prompt and exact diagnosis followed by the appropriate treatment option may prevent the occurrence of testicular cancer or fertility problems that usually develop later in life. After birth, the newborn baby is examined by a doctor. During this examination, Prepubertal Cryptorchidism is easily detected. The baby’s groin area (meaning from the hip down to the scrotum) is very carefully checked. The health care provider decides on the diagnosis if he observes that the testicle (or testes) is not in the normal position inside the scrotum. If any abnormality is detected, the doctor will try to locate the missing testicle in the groin area, especially in the inguinal canal. If the testicle is not found in this region, then ultrasound may be needed to locate the organs in the abdominal area. Along ultrasound, imaging studies, for example X-rays may be very useful to diagnose Prepubertal Cryptorchidism. If further evaluation is needed, the health care provider will refer the baby to a specialist in the area of reproductive and urinary region, called a pediatric urologist.

All these tests must be carefully done in order to differentiate the undescended testicles from retractile testes. In some rarer cases, the testes descend on its own, without medical intervention, usually after four to six months of age. So, it is important that the doctor determines if the testes are unlikely to descend naturally. Now, the specialists can proceed with applying the proper treatment. The most common treatment options that are used by the majority of doctors and considered useful are: surgery, hormonal therapy or a combination of several therapies. Prepubertal Cryptorchidism can be easily cured using a therapy based on hormones because in a normal healthy baby, the process of descending testicles is partially controlled by gonadotropin hormones. So, a normal descent can be induced with the help of HGC (human chorionic gonadotropin), the only hormone approved as a treatment option for Prepubertal Cryptorchidism in the USA. HGC is administrated by injection, twice a week. The surgical procedure is more recommended and it is called orcihidopexy or orchiopexy, being performed when the boy is 1 to 2 years old. The surgeon will do an incision at the scrotum and another one at the groin so that he could manipulate and stitch more easily the testicle into its right place. Laparoscopic techniques are needed if the testes are not located. A therapy based on certain drugs can also be administrated. The most commonly used medicines are: Chorex, Ovidrel, Gonic, Chorigon, Profasi, Choron-10, Pregnyl, Novarel and Profasi HP.