pediatrics
Cryptorchidism
Treatment of Cryptorchidism
Surgical repair For a palpable undescended testis, treatment is surgical orchiopexy, in which the testis is brought into the scrotum and sutured into place; an associated inguinal hernia is repaired if present. For a nonpalpable undescended testis, abdominal laparoscopy is done; if the testis is present, it is moved into the scrotum. If it is atrophic (usually the result of prenatal testicular torsion), the tissue is removed. Surgery should be done at about 6 months of age in term infants and at 1 year of age in preterm infants because early intervention improves fertility potential and may reduce cancer risk. Also, the shorter the child, the shorter the distance necessary to place the testis into the scrotum. No intervention is needed for a retractile testis as long as the spermatic cord length is sufficient to allow the testis to rest in a dependent scrotal position without traction when the cremasteric reflex is not stimulated. Hypermobility usually resolves without treatment by puberty when increased testicular size makes retraction more difficult. 