What Is Cryptorchidism?

Cryptorchidism refers to the failure of one or both testes to descend normally into the scrotum, resulting in an empty scrotum. This condition is known as undescended testis (or cryptorchidism). The exact pathogenesis of cryptorchidism remains unclear but may be associated with endocrine abnormalities during pregnancy or defects in gene expression.

What Is Cryptorchidism?

For cryptorchidism, it is recommended that male infants undergo physical examination shortly after birth to assess whether the testes are present within the scrotum. If ultrasound fails to locate the testis in its expected anatomical positions—such as the retroperitoneum, inguinal canal, or internal inguinal ring—further evaluation is warranted.

In many male infants, over 80% of undescended testes will spontaneously descend into the scrotum within the first year of life. If descent has not occurred by age one year, hormonal therapy is recommended. Human chorionic gonadotropin (hCG) is the preferred agent, administered via intramuscular injection twice weekly for a total dose of 5,000–10,000 units (500 units per injection). A portion of treated cases will achieve spontaneous descent into the scrotum. If the testis remains undescended by age two years, surgical orchidopexy is mandatory.

Cryptorchidism occurs when the testis halts at an intermediate stage of its normal embryonic descent and fails to reach the scrotum. Typically, testicular descent begins around the third month of gestation and is usually completed by birth, with the testes positioned within the scrotum.

If the testis has not descended into the scrotum at birth, spontaneous descent may still occur within the first six months of life. However, if the testis remains undescended beyond six months of age, a diagnosis of cryptorchidism can be established. Management typically involves both conservative (e.g., hormonal) and surgical interventions.