Empty Scrotum

Cryptorchidism is a common disorder in pediatric urology. It has been observed to occur in 3% of term infants and 30% of premature infants; however, 75% and 90% of these undescended testes, respectively, will have spontaneously descended by age 1 year, leaving a true incidence of close to 1% (0.8%) of the male population. Ten percent of cases are bilateral, 3% of which will have one or both testes absent. The etiology is unclear and, although many genetically inherited diseases have a high association with cryptorchidism, most cases of the undescended testis are isolated with no evidence of a genetic component.

SIGNIFICANCE

A 20-fold increased risk of developing a testicular malignancy has been noted with undescended testes. Ten percent of testicular cancers arise in an undescended testis, 60% of which will be seminomas. The intra-abdominal testis is four times more likely to undergo malignant degeneration than an inguinal testis.
Fertility is impaired. Only 30% of patients with bilateral cryptorchidism will be fertile. Spermatogenic damage appears to increase with higher position and longer periods of extrascrotal habitation.
A high incidence of associated inguinal hernias (25%) occurs because of the patent processus vaginalis.
An increased susceptibility to torsion exists, especially in the postpubertal period.

CLASSIFICATION