Discussion of Cryptorchidism
Cryptorchidism is the most common genital problem encountered in pediatrics that represents the failure of testicles to drop into the scrotum before birth. Usually, one testicle is undescended, but about 10% of the cases have both testicles undescended (Lesley et al., 2022). One of the risk factors for cryptorchidism is a low birth weight which suggests intrauterine growth restriction (Braga & Lorenzo, 2017). Maternal factors during pregnancy like preeclampsia, peripartum asphyxia, and complicated deliveries also contribute to cryptorchidism.
Is this condition congenital? Why or why not?
Cryptorchidism is congenital because it is an anomaly that occurs during intrauterine life. Normally, the testis descends in three phases including gonadal differentiation (3-5 weeks), transabdominal descent (10-23 weeks), and inguinal descent (24-34 weeks gestation) (Lesley et al., 2022). A disruption of any of these phases triggered by hereditary, anatomical, environmental, or hormonal factors leads to cryptorchidism (Braga & Lorenzo, 2017). The vast majority of the time, undescended testis move into proper position within three months of life.
Cryptorchidism and Testicular Cancer
Cryptorchidism is associated with impaired fertility and is a great risk factor for testicular cancer (American Cancer Society, 2018). The risk for cancer is reduced when orchiopexy is done before puberty but increases 5 to 6 times if done during later stages of life. Seminoma is the most commonly observed type of testicular cancer in these boys with the peak age ranging from 15 to 45 years (Lesley et al., 2022). Affected individuals should perform regular self-examination for early detection of testicular cancer.
American Cancer Society. (2018). Risk factors for testicular cancer. https://www.cancer.org/cancer/testicular-cancer/causes-risks-prevention/risk-factors.html
Braga, L. H., & Lorenzo, A. J. (2017). Cryptorchidism: A practical review for all community healthcare providers. Canadian Urological Association Journal, S26–S32. https://doi.org/10.5489/cuaj.4343
Leslie, S., Sajjad, H., & Villanueva, C. (2022). Cryptorchidism. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
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