What are the symptoms of cryptorchidism?

Patients with uncomplicated cryptorchidism typically experience no subjective symptoms. The primary clinical manifestation is a flattened scrotum on the affected side; in unilateral cases, asymmetry between the two sides of the scrotum is evident.

In bilateral cryptorchidism, the scrotum appears empty and sunken. If an indirect inguinal hernia develops concurrently, a palpable mass may appear on the affected side after physical activity, accompanied by distension, discomfort, or pain. Severe cases may present with paroxysmal vomiting, abdominal pain, and fever. In cases where the undescended testis undergoes torsion, localized pain occurs, and the affected scrotum lacks a normally positioned testis; gastrointestinal symptoms are relatively mild.

When intrabdominal testicular torsion occurs, pain is typically localized to the lower abdomen near the internal ring. Right-sided intrabdominal cryptorchidism torsion may closely mimic acute appendicitis in terms of symptoms and signs; however, the key distinguishing feature is that the tenderness point in inguinal cryptorchidism torsion lies lower and closer to the internal ring. Moreover, absence of a testis in the affected scrotum should raise high suspicion for intrabdominal testicular torsion.