PubMed · 14321616
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H HORTLING. 1965-08-05. [CRYPTORCHISM].. https://pubmed.ncbi.nlm.nih.gov/14321616/
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Cryptorchidism is the most common genitourinary disorder of childhood, resulting in 27,000 surgical cases each year in the United States. Of the 3% of full-term infants affected, most will have testes that will descend normally within a few months. The remaining 1%, who have a cryptorchid condition that persists, should consider medical or surgical intervention. In addition, although the effect of cryptorchidism on testicular development and fertility has been studied extensively, the only fact of certainty is that untreated men with bilateral abdominal testes will be infertile. The remaining scenarios (unilateral, inguinal, gliding, and medically or surgically treated conditions) offer unpredictable levels of fertility. Fortunately, based on recent research, the correlation between testis maldescent and infertility may not be as prevalent as previously reported.
PURPOSE: It has been speculated that late spontaneous testicular descent occurs in more than 70% of newborns with cryptorchidism. Based on this belief, the decision for orchiopexy is often deferred during infancy. We reviewed our 10-year experience of treating infants with cryptorchidism to document the rate of spontaneous testicular descent. MATERIALS AND METHODS: A total of 1,235 patients with cryptorchidism were referred to our pediatric urology clinic between 1990 and 2000. Of these patients 278 presented before age 12 months. The medical records were reviewed explicitly to document the rate of spontaneous testicular descent. RESULTS: Spontaneous descent occurred in only 6.9% of patients with cryptorchidism reexamined at age 1 year or beyond. All patients with eventual spontaneous descent initially presented by age 6 months. Of those initially presenting beyond age 6 months no patient had spontaneous testicular descent. CONCLUSIONS: Contrary to previous belief, spontaneous testicular descent is uncommon in infants with cryptorchidism and is rare beyond age 6 months.
We report a case of testicular torsion in the left inguinal canal of a 7 month old with a history of cryptorchism and no evidence of neuromuscular disease. We discuss the pathophysiological mechanisms, sonographic findings, and treatment of this rare entity.