Undescended Testis in Boys with Cerebral Palsy Living reference work entry First Online: 10 April 2018 Abstract
Cryptorchidism, or undescended testis, is the most common male reproductive birth defect presenting postnatally or in childhood. The etiology is unknown, but the risk is increased in many syndromic disorders, including cerebral palsy (CP). The frequency has been reported to be 41–54%; however, a recent larger series suggests that 29% of boys with CP have undescended or retractile testes, approximately tenfold greater than the general population. Cryptorchidism risk in CP is independently associated with the severity of spasticity, other congenital anomalies with or without known genetic defects, reduced gestational age, hearing impairment, singleton birth, incontinence, and intrauterine growth restriction (IUGR) but not with brain malformations, hydrocephalus, intellectual disability (ID), gastrostomy use, or vision or speech impairment. The association with spasticity and with presentation later in childhood in this population suggests that an “acquired” presentation is common, possibly due to cremaster muscle spasticity. However, the association with other congenital anomalies suggests that genetic causes may also contribute significantly to co-occurrence of cryptorchidism with CP. In the general population, cryptorchidism is associated with increased risk of subfertility and testicular malignancy, but the level of these risks in the CP population is not defined. Undescended testes are also at higher risk for torsion, which may be difficult to diagnose in patients with ID. Except in high-risk, complex patients, surgical correction is indicated.
Keywords Undescended testis Cryptorchidism Cremaster muscle Retractile testis References
Barthold JS, Hossain J, Olivant-Fisher A, Reilly A, Figueroa TE, Banihani A, Hagerty J, Gonzalez R, Noh PH, Manson JM (2012) Altered infant feeding patterns in boys with acquired nonsyndromic cryptorchidism. Birth Defects Res A Clin Mol Teratol 94(11):900–907.
https://doi.org/10.1002/bdra.23075 CrossRef PubMed PubMedCentral Google Scholar
Barthold JS, Reinhardt S, Thorup J (2016) Genetic, maternal, and environmental risk factors for cryptorchidism: an update. Eur J Pediatr Surg 26(5):399–408.
https://doi.org/10.1055/s-0036-1592416 CrossRef PubMed Google Scholar
Blair EM, Nelson KB (2015) Fetal growth restriction and risk of cerebral palsy in singletons born after at least 35 weeks’ gestation. Am J Obstet Gynecol 212(4):520 e521–520 e527.
https://doi.org/10.1016/j.ajog.2014.10.1103 CrossRef Google Scholar
Cortada X, Kousseff BG (1984) Cryptorchidism in mental retardation. J Urol 131(4):674–676
CrossRef Google Scholar
Depue RH (1988) Cryptorchidism, and epidemiologic study with emphasis on the relationship to central nervous system dysfunction. Teratology 37(4):301–305.
https://doi.org/10.1002/tera.1420370403 CrossRef PubMed Google Scholar
Fahey MC, Maclennan AH, Kretzschmar D, Gecz J, Kruer MC (2017) The genetic basis of cerebral palsy. Dev Med Child Neurol 59(5):462–469.
https://doi.org/10.1111/dmcn.13363 CrossRef PubMed Google Scholar
Garne E, Dolk H, Krageloh-Mann I, Holst Ravn S, Cans C, Group SC (2008) Cerebral palsy and congenital malformations. Eur J Paediatr Neurol 12(2):82–88.
https://doi.org/10.1016/j.ejpn.2007.07.001 CrossRef PubMed Google Scholar
Ghalige HS, Babitha N, Maibam C, Sharma MB, Singh TS (2014) Testicular torsion in cerebral palsy – resident’s grey area. J Clin Diagn Res 8(10):ND07-09.
https://doi.org/10.7860/JCDR/2014/10154.5054 CrossRef Google Scholar
Gurney JK, McGlynn KA, Stanley J, Merriman T, Signal V, Shaw C, Edwards R, Richiardi L, Hutson J, Sarfati D (2017) Risk factors for cryptorchidism. Nat Rev Urol 14(9):534–548.
https://doi.org/10.1038/nrurol.2017.90 CrossRef PubMed PubMedCentral Google Scholar
Harper L, Michel JL, De Napoli-Cocci S (2010) Should we perform orchidopexy for cryptorchidism in children with severe encephalopathy? J Pediatr Urol 6(3):274–276.
https://doi.org/10.1016/j.jpurol.2009.08.011 CrossRef PubMed Google Scholar
Jacobsson B, Ahlin K, Francis A, Hagberg G, Hagberg H, Gardosi J (2008) Cerebral palsy and restricted growth status at birth: population-based case-control study. BJOG 115(10):1250–1255.
https://doi.org/10.1111/j.1471-0528.2008.01827.x CrossRef PubMed Google Scholar
Kolon TF, Herndon CD, Baker LA, Baskin LS, Baxter CG, Cheng EY, Diaz M, Lee PA, Seashore CJ, Tasian GE, Barthold JS, American Urological A (2014) Evaluation and treatment of cryptorchidism: AUA guideline. J Urol 192(2):337–345.
https://doi.org/10.1016/j.juro.2014.05.005 CrossRef PubMed Google Scholar
MacLennan AH, Thompson SC, Gecz J (2015) Cerebral palsy: causes, pathways, and the role of genetic variants. Am J Obstet Gynecol 213(6):779–788.
https://doi.org/10.1016/j.ajog.2015.05.034 CrossRef PubMed Google Scholar
Nelson KB, Blair E (2015) Prenatal factors in cerebral palsy. N Engl J Med 373(23):2288–2289.
https://doi.org/10.1056/NEJMc1512559 CrossRef PubMed Google Scholar
Rankin J, Cans C, Garne E, Colver A, Dolk H, Uldall P, Amar E, Krageloh-Mann I (2010) Congenital anomalies in children with cerebral palsy: a population-based record linkage study. Dev Med Child Neurol 52(4):345–351.
https://doi.org/10.1111/j.1469-8749.2009.03415.x CrossRef PubMed Google Scholar
Reid SM, Modak MB, Berkowitz RG, Reddihough DS (2011) A population-based study and systematic review of hearing loss in children with cerebral palsy. Dev Med Child Neurol 53(11):1038–1045.
https://doi.org/10.1111/j.1469-8749.2011.04069.x CrossRef PubMed Google Scholar
Rundle JS, Primrose DA, Carachi R (1982) Cryptorchism in cerebral palsy. Br J Urol 54(2):170–171
CrossRef Google Scholar
Samijn B, Van den Broeck C, Deschepper E, Renson C, Hoebeke P, Plasschaert F, Vande Walle J, Van Laecke E (2017) Risk factors for daytime or combined incontinence in children with cerebral palsy. J Urol 198(4):937–943.
https://doi.org/10.1016/j.juro.2017.05.067 CrossRef PubMed Google Scholar
Smith JA, Hutson JM, Beasley SW, Reddihough DS (1989) The relationship between cerebral palsy and cryptorchidism. J Pediatr Surg 24(12):1303–1305
CrossRef Google Scholar
Springer A, Kidger E, Krois W, Fengler D, Reck CA, Horcher E (2013) Decision making among different treatment options for neurologically impaired boys with undescended testis: a multinational pediatric survey. J Pediatr Urol 9(1):42–45.
https://doi.org/10.1016/j.jpurol.2011.11.009 CrossRef PubMed Google Scholar Copyright information
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