Cryptorchidism and Retractile Testis

Abstract

Cryptorchidism is one of the most common diseases seen in daily practice for the pediatric surgeons; incidence of congenital undescended testis is approximately 1–1.5 %. Orchiopexy is the most recommended treatment for cryptorchidism to prevent secondary degeneration of the testis and increasing risk of malignancy. Although orchiopexy tends to be seemed the operation for the beginner surgeons, a skilled technique is required to dissect the frail vas deferens and testicular blood vessels in the procedure for the fertility improvement. Because spontaneous descent can be expected until a corrected age of 3–6 months, orchiopexy is performed after 6 months of age depending on the surgeon’s experience; fertility improvement and the preventive effect of testicular tumor are expected by early surgery (Thorup et al. J Pediatr Surg. 2010;45:2074–86). We describe the open surgery for groin undescended testis and the laparoscopic surgery for abdominal testis in this chapter. Orchiopexy is not required for a typical case of retractile testis that shows reflex ascent in response to the thigh skin stimulation and soon descends down in the scrotum; the indications for orchiopexy in retractile testis are (1) small testis compared to contralateral one, (2) indistinguishable testis from cryptorchidism, (3) testis which is always in the groin with atrophic scrotum, and (4) testis combined with inguinal hernia.

The figures in this chapter are reprinted with permission from Standard Pediatric Operative Surgery (in Japanese), Medical View Co., Ltd., 2013, with the exception of occasional newly added figures that may appear.