Paediatrics

Cryptorchidism (Undescended Testis)

Cryptorchidism is failure of one or both testes to lie in the scrotum; persistent extrascrotal testes carry fertility, malignancy and torsion risks, so current NHS screening requires timely examination, referral and specialist orchidopexy planning.

Definition

Cryptorchidism is failure of one or both testes to lie in the scrotum, with the testis located along the normal path of descent, in an ectopic position or absent. It includes congenital and acquired ascending testes but excludes a testis that is merely retractile and can remain scrotal.

First principles

Descent is a late fetal process

The testes develop in the abdomen and normally descend through the inguinal canal into the scrotum late in pregnancy. Prematurity and low birth weight increase the chance that descent is incomplete at birth; some testes descend spontaneously in early infancy.

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