Cryptorchidism Cryptorchidism is a condition in which one or both testes fail to descend into the scrotum before birth. It is one of the most common congenital anomalies of the male genitalia and can lead to various complications if not addressed. 1. Definition and Incidence: o Definition: Cryptorchidism refers to the absence of one or both testes from the scrotum. The testes may be located in the abdomen, inguinal canal, or other abnormal positions. o Incidence: It occurs in approximately 3% of full-term newborns and up to 30% of premature infants. The condition is more common in premature infants and those with low birth weight. 2. Types: o Unilateral Cryptorchidism: One testis is undescended. o Bilateral Cryptorchidism: Both testes are undescended. o Retractile Testis: A testis that can be brought into the scrotum manually but returns to a higher position due to muscle contraction. This is not considered true cryptorchidism but requires monitoring. 3. Causes: o Developmental Factors: The exact cause of cryptorchidism is often unknown, but it is thought to involve developmental and hormonal factors that affect testicular descent. o Genetic Factors: Genetic mutations and family history may contribute to the condition. o Environmental Factors: Exposure to certain environmental factors, such as endocrine disruptors, may be associated with an increased risk. 4. Diagnosis: o Clinical Examination: Diagnosis is primarily based on physical examination. In a newborn or infant, the absence of one or both testes from the scrotum is noted. o Imaging Studies: In cases where the testis cannot be palpated, imaging studies such as ultrasound or MRI may be used to locate the undescended testis. 5. Complications: o Infertility: The undescended testis may lead to impaired spermatogenesis due to higher temperatures in the abdominal cavity. o Increased Risk of Testicular Cancer: There is an increased risk of testicular cancer in undescended testes, particularly if left untreated. o Testicular Torsion: The undescended testis is at risk for torsion, which can cause acute pain and loss of the testis if not promptly treated. o Psychosocial Impact: Concerns about physical appearance and potential sexual function may affect the individual’s psychological well-being. 6. Treatment: o Surgical Intervention: The primary treatment is orchidopexy, a surgical procedure to reposition the undescended testis into the scrotum. This is ideally performed between 6 and 18 months of age. o Hormonal Therapy: In some cases, hormonal therapy with human chorionic gonadotropin (hCG) or luteinizing hormone-releasing hormone (LHRH) may be used to stimulate testicular descent before surgery. o Follow-Up: Regular follow-up is necessary to monitor testicular position and function, as well as to manage any complications. Prevention and Monitoring:  Early diagnosis and intervention are crucial to minimize long-term complications. Routine pediatric evaluations and monitoring are essential to ensure optimal outcomes for affected individuals.