What factors cause cryptorchidism in males?

Undescended testis in males, also known as cryptorchidism, refers to the failure of one or both testes to fully descend into the scrotum. Common causes include genetic factors, prematurity, hormonal abnormalities, trauma, and congenital adrenal hyperplasia. Individuals experiencing abnormalities should seek timely medical evaluation to determine the underlying cause and receive targeted treatment. Detailed analysis is as follows:

1. Genetic Factors

Cryptorchidism is associated with genetic inheritance. If there is a family history of undescended testes, the risk of offspring developing the condition increases. Genetically caused cryptorchidism typically presents without other abnormalities, and early diagnosis followed by prompt surgical intervention is crucial. Surgery should be performed at an appropriate age to reduce the risk of complications and support future fertility.

2. Prematurity

Testicular descent is a progressive process that usually completes during the late stages of pregnancy. Premature birth means the infant is born before this process is complete, which may result in undescended testes at birth, along with other symptoms of prematurity such as low birth weight and respiratory difficulties. In such cases, physicians generally recommend observation for several months up to a year, allowing time for the testes to descend naturally.

3. Hormonal Abnormalities

In male fetuses, normal secretion of sex hormones such as testosterone plays a critical role in testicular descent. Abnormal hormone levels—particularly insufficient testosterone—may prevent the testes from descending properly into the scrotum, causing them to remain in the abdominal cavity or inguinal canal. Cryptorchidism caused by hormonal imbalances can be treated with testosterone supplementation or other forms of hormone replacement therapy to promote testicular descent.

4. Trauma

Trauma can disrupt the normal structure of the testes and surrounding tissues, impairing both descent and fixation of the testes, potentially leading to cryptorchidism. Treatment for trauma-induced cryptorchidism depends on the specific injury. Common surgical options include orchiopexy, laparoscopic orchiopexy, long-loop vas deferens orchiopexy, autologous testicular transplantation, and, when necessary, orchiectomy.

5. Congenital Adrenal Hyperplasia (CAH)

Hormonal imbalances caused by congenital adrenal hyperplasia—especially abnormal levels of androgens and cortisol—can interfere with the hormonal signals required for testicular descent, resulting in cryptorchidism. Children with CAH may also present with electrolyte disturbances and hypertension. Treatment typically involves hormone replacement therapy, such as administration of human chorionic gonadotropin (hCG), luteinizing hormone-releasing hormone (LHRH), and glucocorticoids, along with monitoring and correction of electrolyte imbalances. Surgical intervention may be necessary in some cases.

Proper care can help alleviate discomfort in patients with cryptorchidism and support recovery. Patients should maintain a positive mindset, adopt healthy lifestyle habits, and attend regular follow-up appointments.