Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ Affects 2–4% of full-term male newborns and up to 30% of premature infants After 6 months of age, spontaneous descent occurs only very rarely Can occur in an isolated fashion or associated with other findings Abnormalities in the hypothalamic-pituitary-gonadal axis and androgen biosynthesis or receptor defects predispose to cryptorchidism Fertility is impaired by approximately 33% after unilateral cryptorchidism and by 66% after bilateral disease Risk of cancer in adults with history of cryptorchidism in childhood is reported to be 5–10 times greater than normal However, histologic changes clearly occur as early as age 6 months in children with undescended testes +++ Clinical Findings ++ During examination, the cremasteric reflex may cause the testis to retract into the inguinal canal or abdomen (pseudocryptorchidism) To prevent retraction, the fingers are placed across the abdominal ring and the upper portion of the inguinal canal Examination in the squatting position or in a warm bath is helpful +++ Diagnosis ++ In infants between 2 and 6 months of age, measurement of luteinizing hormone, follicle-stimulating hormone, inhibin B, and testosterone can help determine whether testes are present After this time, an HCG stimulation test can be done to confirm the presence or absence of functional abdominal testes Ultrasonography, CT scanning, and MRI May detect testes in the inguinal region However, these studies are not completely reliable in finding abdominal testes Diagnosis of bilateral cryptorchidism in an apparently normal male newborn should never be made until the possibility that the child is actually a fully virilized female with potentially fatal salt-losing CAH has been considered +++ Treatment ++ No treatment is necessary for retractile testes Surgical orchidopexy should be performed if descent has not occurred by 6–12 months of age Therapy with HCG to induce descent of the testis has a success rate of about 20%, and even less when retractile testes are excluded HCG doses range from 250 to 1000 international units and are given twice weekly for 5 weeks Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.