Patient's question:
I was born with "unilateral cryptorchidism." I had surgery at the age of 13, and now one testicle is half in the scrotum and half in the lower abdomen. I am 20 now, and sometimes I feel a slight pain in the lower abdomen while playing basketball.1 What should I do?
2 What should I pay attention to in daily diet/activity?
3 Is there any danger!?
Doctor's answer:
Undescended testes refer to the congenital absence of testes within the scrotum, which includes undescended testes, ectopic testes, and testicular agenesis. Undescended testes occur when the descent of the testes is impaired, causing them to remain along the path of descent without entering the scrotum. Clinically, undescended testes are often referred to as cryptorchidism. Ectopic testes are those that deviate from the normal descent pathway, reaching the perineum, thigh, suprapubic region, or even the contralateral scrotum. Testicular agenesis refers to the absence of one or both testes, accounting for approximately 3–5% of cases of undescended testes. In newborns, about 4–10% of male infants are born with testes that have not fully descended into the scrotum, and they continue to descend postnatally. By the age of one, the incidence of cryptorchidism drops to only 1–2%, and in adults, it is around 0.4%. Unilateral cryptorchidism is more common than bilateral, with a ratio of approximately 5:1. Testes that remain in the abdominal or inguinal region due to high temperatures compared to the scrotum may develop poorly over time, leading to atrophy of the seminiferous tubules and impaired spermatogenesis. Over time, cryptorchid testes may also transform into testicular tumors, making early treatment and repositioning into the scrotum essential to avoid complications.A unilateral or bilateral atrophic scrotum, with no testes palpable within the scrotum, may have testis-like masses in the inguinal region or symptoms of inguinal hernia. If the cryptorchid testes have become malignant, a lump may sometimes be palpable in the abdomen or inguinal region. In adults with bilateral cryptorchidism, infertility may occur.
Endocrine treatment and surgical treatment.
Cryptorchidism should be treated with repositioning before the age of 2, with the latest not exceeding 5–6 years.
Testes located in the inguinal region can be palpated during examination, and no special localization tests are needed. If necessary