What is the fertility rate of unilateral occult testis?

Cryptorchidism refers to the failure of the testicles to descend to the scrotum, including incomplete testicular descent and disordered testicles. In clinical medicine, the vast majority of cryptorchidism is incomplete testicular descent. Dysfunction testicles are most often located in the shallow groin fossa. 80% of cryptorchidism can be touched, 20% cannot be touched, about 20% of inaccessible testicles are testicular deficiency, and 30% are testicular atrophy. Children can retract their testicles, and generally only need to follow up to confirm that the testicles are in a normal state and not retracted. When bilateral anorchiasis is diagnosed, the male chromosome karyotype must be determined and an endocrinological evaluation is necessary to help distinguish whether unilateral or unilateral testis is present.

Cryptorchidism is caused by abnormal testicular descent. There are many factors that cause abnormal testicular descent, the most common of which are:

1. The gubernaculum that guides the testicles into the scrotum is abnormally deficient, so that the testicles cannot descend from their original position into the scrotum.

2. Congenital male testicular dysplasia makes male testicles less sensitive to gonadotropin, resulting in loss of driving force.

3. The luteinizing hormone produced by the hypothalamus pituitary gland releases growth hormone, which causes the pituitary gland to secrete insufficient LH and follicle-stimulating hormone FSH, which can also affect the driving force of testicular descent. Those caused by endocrine factors are often bilateral cryptic testis, while those caused by other factors are often unilateral cryptic testis. Sometimes cryptic testis can be combined with inguinal oblique hernia.

Clinical symptoms

1. Infertility

Cryptorchidism can cause somatic cell damage. Surgical treatment should be performed as soon as possible to fix the male testicles to the scrotum to reduce the risk of reduced fertility. The earliest postpartum histological abnormality of cryptorchidism is the dysplasia of interstitial cells that can be observed in the first month after birth. Unilateral cryptorchidism after puberty should be removed because it is prone to deterioration and distortion in the future. The vast majority of male testicles have lost their fertility function.

2. Deterioration

Adolescents born with undescended testicles are at risk for developing malignant testicular tumors. The incidence of somatic cell tumors in men with occult testes is about 40 times higher than in the general population. The location of undescended testicles affects the relative risk of developing testicular tumors. The higher the location, the greater the risk of malignancy. Half of the intra-abdominal male testicles will develop malignant changes. The most common type of male testicular tumor arising from the male testicles is seminoma. The incidence of carcinoma in situ in patients with occult testes is 1.7%.

3. Hernia

90% of male patients with undescended testes have a patent processus vaginalis. The processus vaginalis usually closes after testicular descent and within the first month after birth. A patent processus vaginalis is associated with a higher risk of epididymal cysts. The clinical manifestation of a patent processus vaginalis is that it can affect the actual effect of hormone treatment for cryptic testis.

4. Testicular torsion

Cryptorchidism may have abnormalities in the adhesions of the gubernaculum, levator testis, or tunica vaginalis, which can lead to testicular torsion. Although undecapitated testicles rarely torsion, testicular torsion should be considered in patients with abdominal or groin pain accompanied by lateral scrotal discomfort.