Skip to main content
SpringerLink
Log in

Imaging the Undescended Testis

  • Chapter
Scrotal Pathology

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 2285 Accesses

Abstract

Undescended testis, i.e., cryptorchidism, implies failure of testicular descent into the scrotum with concomitant abnormality in testicular development. It represents an important clinical entity because of its close association with infertility and testicular malignancy. Abnormalities in anatomical and hormonal factors involved in embryogenesis and testicular descent may all have a role in the etiology of cryptorchidism, though the exact mechanism is not fully understood. The diagnosis of the entity depends mainly on laparoscopy and the role of imaging is controversial, though diagnostic imaging has been considered to be helpful particularly for the evaluation of patients with a nonpalpable undescended testis. US is the most common diagnostic imaging study employed in the evaluation of cryptorchidism. The technique is accepted as the first step after clinical evaluation, whereas MRI has been proposed as the modality of choice preoperatively when US findings are negative.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Agarwal PK, Diaz M, Elder JS (2006) Retractile testis is it really a normal variant? J Urol 175:1496–1499

    Article  PubMed  Google Scholar 

  • Burgu B, Baker LA, Docimo SG (2010) Cryptorchidism. In: Gearhart JP, Rink RC, Mouriquand PDE (eds) Pediatric Urology, second edn. Elsevier, Philadelphia

    Google Scholar 

  • Cain MP, Gara B, Gibbons MD (1996) Scrotal-inguinal ultrasonography: a technique for identifying the nonpalpable inguinal testis without laparoscopy. J Urol 156:791–794

    Article  PubMed  CAS  Google Scholar 

  • Christensen JD, Dogra VS (2007) The undescended testis. Semin Ultrasound CT MRI 28:307–316

    Article  Google Scholar 

  • Cortes D (1998) Cryptorchidism-aspects of pathogenesis, histology and treatment. Scand J Urol Nephrol Suppl 196:1–54

    PubMed  CAS  Google Scholar 

  • Cortes D, Thorup J, Petersen BL (2006) Testicular histology in cryptorchid boys- aspects of fertility. J Pediatr Surg Special 1:34–37

    Google Scholar 

  • De Filippo RE, Barthold JS, Gonzales R (2000) The application of magnetic resonance imaging for the preoperative localization of nonpalpable testis in obese children: an alternative to laparoscopy. J Urol 164:154–155

    Article  PubMed  Google Scholar 

  • Desireddi NV, Liu DB, Maizels M et al (2008) Magnetic resonance arteriography/venography is not accurate to structure management of the inpalpable testis. J Urol 180:1805–1809

    Article  PubMed  Google Scholar 

  • Dogra VS, Gottlieb H, Oka M et al (2003) Sonography of the scrotum. Radiology 227:18–36

    Article  PubMed  Google Scholar 

  • Dogra VS, Bhatt S, Rubens DJ (2006) Sonographic evaluation of testicular torsion. Ultrasound Clin 1:55–66

    Article  Google Scholar 

  • Eggener SE, Lotan Y, Cheng EY (2005) Magnetic resonance angiography for the nonpalpable testis: a cost and cancer risk analysis. J Urol 173:1745–1750

    Article  PubMed  CAS  Google Scholar 

  • Elder JS (2002) Ultrasonography is unnecessary in evaluating boys with a nonpalpable testis. Pediatrics 110:748–751

    Article  PubMed  Google Scholar 

  • Fenton EJM, Woodward AA, Hudson IL et al (1990) The ascending testis. Pediatr Surg Int 4:6–9

    Google Scholar 

  • Gatti JM, Ostlie DJ (2007) The use of laparoscopy in the management of nonpalpable undescended testes. Curr Opin Pediatr 19:349–353

    Article  PubMed  Google Scholar 

  • Giannopoulos MF, Vlachakis IG, Charissis GC (2001) 13 years’ experience with the combined hormonal therapy of cryptorchidism. Horm Res 55:33–37

    Article  PubMed  CAS  Google Scholar 

  • Giwercmann A, Brunn E, Frimodt-Moller C et al (1989) Prevalance of carcinoma in situ and other histopathological abnormalities in testes of men with a history of cryptorchidism. J Urol 142:998–1001

    Google Scholar 

  • Heyns CF (1987) The gubernaculum during testicular descent in the human fetus. J Anat 153:93–112

    PubMed  CAS  Google Scholar 

  • Heyns CF, Hutson JM (1995) Historical review of theories in testicular descent. J Urol 153:754–767

    Article  PubMed  CAS  Google Scholar 

  • Huff DS, Hadziselimovic F, Synder HM III et al (1991) Early postnatal testicular development in cryptorchidism. J Urol 146:624–626

    PubMed  CAS  Google Scholar 

  • Huff DS, Hadziselimovic F, Synder HM III et al (1993) Histologic maldevelopment of unilaterally cyrptorchid testes and their descended partners. Eur J Pediatr 152(suppl 2):10–14

    Article  Google Scholar 

  • Hutson JM, Hasthorpe S (2005a) Abnormalities of testicular descent. Cell Tissue Res 322:155–158

    Article  PubMed  Google Scholar 

  • Hutson JM, Hasthorpe S (2005b) Testicular descent and cryptorchidism: the state of art in 2004. J Pediatr Surg 40:297–302

    Article  PubMed  Google Scholar 

  • Hutson JM, Terada M, Zhou B et al (1995) Normal testicular descent and aetiology of cryptorchidism. Adv Anat Embryol Cell Biol 132:1–56

    Article  Google Scholar 

  • Hutson JM, Hasthorpe S, Heyns CF (1997) Anatomical and functional aspects of testicular descent and cryptorchidism. Endocr Rev 18:259–280

    Article  PubMed  CAS  Google Scholar 

  • Kanemoto K, Hayashi Y, Kojıma Y et al (1986) Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of non-palpable testis. Int J Urol 12:668–672

    Article  Google Scholar 

  • Kaplan LM, Kolye MA, Kaplan GW et al (1986) Association between abdominal wall defects and cryptorchidism. J Urol 136:645–657

    PubMed  CAS  Google Scholar 

  • Kier R, McCarthy S, Rosenfield AT et al (1988) Nonpalpable testes in young boys:evaluation with MR imaging. Radiology 169:429–433

    PubMed  CAS  Google Scholar 

  • La Scala GC, Ein SH (2004) Retractile testes: an outcome analysis on 150 patients. J Pediatr Surg 39:1014–1017

    Article  PubMed  Google Scholar 

  • Lam WWM, Tam PK, Ai VH et al (2001) Using gadolinium-infusion MR venography to show the impalpable testis in pediatric patients. Am J Roentgenol 176:1221–1226

    CAS  Google Scholar 

  • Lee JK, Glazer HS (1982) Computed tomography in the localization of the nonpalpable testis. Urol Clin North Am 9:397–404

    PubMed  CAS  Google Scholar 

  • Moore KL, Persaud TVN (1993) The developing human: clinically oriented embryology. Saunders, Philadelphia

    Google Scholar 

  • Nijs SMP, Eijbouts SW, Madern GC et al (2007) Nonpalpable testis: is there a relationship between ultrasonographic and operative findings? Pediatr Radiol 37:374–379

    Article  PubMed  Google Scholar 

  • O’Hali W, Anderson P, Giacomantonio M (1997) Management of impalpable testes; indications for abdominal exploration. J Pediatr Surg 32:918–920

    Article  PubMed  Google Scholar 

  • Ong C, Hasthorpe S, Hutson JM (2005) Germ cell development in the descended and cryptorchid testis and the effects of hormonal manipulation. Pediatr Surg Int 21:240–254

    Article  PubMed  CAS  Google Scholar 

  • Pettersson A, Richiardi L, Nordenskjold A et al (2007) Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med 356:1835–1841

    Article  PubMed  CAS  Google Scholar 

  • Pincowzki D, McLaughlin JK, Lackgren G et al (1991) Occurence of testicular cancer in patients operated on for cryptorchidism and inguinal hernia. J Urol 146:1291–1294

    Google Scholar 

  • Ritzen EM (2008) Undescended testis: a consensus on management. Eur J Endocrinol 159:87–90

    Article  Google Scholar 

  • Ritzen EM, Bergh A, Bjerknes R et al (2007) Nordic consensus on treatment of undescended testes. Acta Paediatr 96:638–643

    Article  PubMed  Google Scholar 

  • Rosenfield AT, Blair DN, McCarthy S et al (1989) The pars infravaginalis gubernaculi: importance in the identification of the undescended testis. Am J Roentgenol 153:775–778

    CAS  Google Scholar 

  • Sarihan H, Sari A, Abes M et al (1998) Nonpalpable undescending testis: value of magnetic resonance imaging. Minerva Urol Nefrol 50:233–236

    PubMed  CAS  Google Scholar 

  • Snodgrass WT, Yucel S, Ziada A (2007) Scrotal exploration for unilateral nonpalpable testis. J Urol 178:1718–1721

    Article  PubMed  Google Scholar 

  • Taran I, Elder JS (2006) Results of orchiopexy for the undescended testis. World J Urol 24:231–239

    Article  PubMed  Google Scholar 

  • Virtanen HE, Cortes D, De Meyts ER et al (2007) Developement and descent of the testis in relation to cryptorchidism. Acta Paediatr 96:622–627

    Article  PubMed  Google Scholar 

  • Whitaker RH (1988) 9 Neoplasia in crytorchid men. Semin Urol 6:107–109

    PubMed  CAS  Google Scholar 

  • Wolverson MK, Houttin E, Heiberg E et al (1983) Comparision of computed tomography with high resolution real-time ultrasound in the localization of the impalpable undescended testis. Radiology 146:133–136

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We would like to acknowledge our sincere thanks to Tarkan Soygür, MD for his providing Figs. 1, 2, and 4 and Suat Fitöz, MD for his providing Fig. 8.

Author information

Authors and Affiliations

  1. Department of Urology, Ankara University School of Medicine, 06100, Ankara, Turkey

    Eriz Özden

  2. Department of Radiology, Ankara Training and Research Hospital, 06590, Ankara, Turkey

    Ahmet T. Turgut

  3. Department of Imaging Sciences, University of Rochester School of Medicine, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA

    Vikram S. Dogra

Authors
  1. Eriz Özden
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmet T. Turgut
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vikram S. Dogra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eriz Özden .

Editor information

Editors and Affiliations

  1. Ospedale di Cattinara, Ist. Radiologia, Università Trieste, Strada di Fiume 149, Trieste, 34149, Italy

    Michele Bertolotto

  2. Ospedale di Cattinara, Department of Urology, University of Trieste, Strada di Fiume 447, Trieste, 34149, Italy

    Carlo Trombetta

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Özden, E., Turgut, A.T., Dogra, V.S. (2011). Imaging the Undescended Testis. In: Bertolotto, M., Trombetta, C. (eds) Scrotal Pathology. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_195

Download citation

  • DOI: https://doi.org/10.1007/174_2011_195

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-12455-6

  • Online ISBN: 978-3-642-12456-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation