Cryptorchidism

anorchia

A condition of absent testes

Diagnostic Test Results-Imaging

Computed tomography scanning or magnetic resonance angiography may identify testicular tissue.

What is cryptorchidism?

Congenital disorder in which one or both testes fail to descend into the scrotum, remaining in the abdomen or inguinal canal or at the external ring May be bilateral, but more commonly affects the left testis

Overview-Incidence

Cryptorchidism occurs predominantly in premature male neonates. It occurs in 30% of premature male neonates and in only 3% of full-term male neonates. Spontaneous descent occurs by 1 to 3 months of age in approximately 50% to 70% of full-term males.

Nursing Considerations-Nursing Interventions

Encourage the parents of the child with undescended testes to express their concern about his condition. Administer an HCG injection as ordered biweekly for 4 to 5 weeks to assist in testicular descent.

Overview-Causes

Exact mechanism not known Multifactorial Genetic predisposition Hormonal factors Structural factors

Treatment-Medications

HCG

Overview-Pathophysiology

In the male fetus, testosterone normally stimulates the formation of the gubernaculum. A fibromuscular band connects the testes to the scrotal floor. This band probably helps pull the testes into the scrotum by shortening as the fetus grows.

Diagnostic Test Results-Laboratory

Luteinizing hormone, follicle-stimulating hormone, and testosterone levels to determine if testes should be present in boys younger than age 3 months Human chorionic gonadotropin (HCG) stimulation test (in boys older than age 3 months) to determine the presence or absence of testicular tissue

Assessment-Physical Findings

Nonpalpable testes small, flat Underdeveloped scrotum

Treatment-Surgery

Orchiopexy

plan for cryptorchidism

Prepare the parents for possible surgery, typically performed before the child is age 1 year, usually between ages 6 to 12 months. Provide postoperative care as indicated, including pain relief.

Overview-Complications

Sterility Increased risk of testicular cancer Hernia development

orchioplexy

Surgical placement of testes in scrotum

when do testes usually descend?

at end of first year