"COMPLICATIONS
1. Prone to malignancy (10 times higher)
2. Prone to infertiltiy
3. Prone to trauma when it is in inguinal canal
DIFFERENTIAL DIAGNOSIS
1) Ectopic testis : deviated f rom normal path of descent af ter it has emerged through the
external inguinal ring. It may be found:
� in the superf icial inguinal pouch
� in the perineum
� at the root of the penis
� in the f emoral canal
The ectopic testis cannot be pushed down into the scrotum.
2) Retractile testes
- occurs because of the cremasteric ref lex that retracts the testicles
- Once a testicle has been discovered in the scrotum
it is generally considered descended even if it is
temporarily pulled back .
- Ask mother if she has ever seen the testicle in the scrotum. If she aff irms this
no treatment is required.
- It may be possible to �milk� the testes down into the scrotum during examination.
Neither the ectopic nor the retractile testes
need treatment.
MANAGEMENT:
A. FOR A PALPABLE TESTES
1) Orchidopexy :
To reduce chance of infertility.
It does not reduce the chances of malignant transformation!
B. Hormonal treatment with gonadotrophins if :
� there is bilateral incomplete descent associated with hypogenitalism and obesity.
C. Orchidectomy : If the patient presents after puberty
orchidectomy to remove a testes that
is unlikely to produce sperm but also carries a cancer risk.
FOR THE IMPALPABLE TESTES:
1 ) MRI to determine presence or absence of an intra abdominal testes may be congenitally absent).
2) Laparoscopy to remove testes if one is found.
"