Maldescensus testisQ53.95
Synonym(s)
Cryptorchidism; ectopia testis; Pendulum testicles; retentiontio testis; Sliding testicles; Testicular kidney; Testicular retention
Requires free registration (medical professionals only)
Please login to access all articles, images, and functions.
Our content is available exclusively to medical professionals. If you have already registered, please login. If you haven't, you can register for free (medical professionals only).
Sign up now for free!Already registered? Click here to login.Requires free registration (medical professionals only)
Please complete your registration to access all articles and images.
To gain access, you must complete your registration. You either haven't confirmed your e-mail address or we still need proof that you are a member of the medical profession.
Finish your registration nowDefinitionThis section has been translated automatically.
Absence of the Descensus testis (one or both sides). The testes normally lie in the scrotum at birth (96-97%), but should be descended by the end of the first year of life at the latest, as the physiological development of the testes occurs only in the case of (predominantly) intrascrotal position.
Clinical featuresThis section has been translated automatically.
According to the position of the testis different forms are distinguished, see table 1.
Differential diagnosisThis section has been translated automatically.
Testicular aplasia in the case of retention testis abdominalis and ectopia testis, inguinal hernia in the case of retention testis inguinalis.
General therapyThis section has been translated automatically.
By urologists or pediatricians. With the exception of the sliding or pendulum testis, any positional anomaly should be treated between 3 months and 2 years of age. It is recommended to start therapy at the age of 10 months.
Internal therapyThis section has been translated automatically.
Initially already in the 10th month of life
GnRH (e.g. Kryptocur) intranasally over 4 weeks, 3 times/day 1 spray in each nostril, wait for results over 2-4 weeks. In the absence of success, parenteral HCG therapy (e.g. Predalon) with approx. 500-1500 IU/week (depending on age, pediatrician!) over 3-4 weeks.
Operative therapieThis section has been translated automatically.
If conservative treatment is unsuccessful (approx. 3-4 months after hormonal therapy), surgical treatment with orchidopexy by urologists. Before surgical therapy, renewed HCG cycle over 3-5 weeks, 2 times 250 IU HCG/week, in older children (6-12 years) or in adolescents increase the dose to 2 times 500 up to max. 2 times 1000 IU HCG/week over the same period.
- Ectopic testicles are primarily removed surgically because of the danger of degeneration.
- In case of pendulum testis which do not remain permanently intrascrotal at the end of puberty, surgical treatment by orchidopexy.
Progression/forecastThis section has been translated automatically.
If the tests are retained beyond the age of 6 years, the germinal epithelium shows considerable damage, which can make a later sufficient spermiogenesis (fertility) impossible. Increased risk of degeneration of retained testicles!
TablesThis section has been translated automatically.
Classification of the maldescensus testis
Classification |
Clinic |
Therapy |
Retentio testis abdominalis (abdominal testicles) |
Testicles not palpable. |
Hormonal, possibly surgical. |
Retentio testis inguinalis (inguinal testicles) |
Testicles in the inguinal canal or in front of the outer inguinal ring palpable, cannot be relocated into the scrotum. |
Hormonally, if necessary surgically. |
Testis mobilis (sliding or pendulum testis) |
Sliding testis: Under tension of the spermatic cord structures the testis can be shifted to the upper scrotum. Afterwards it immediately slides back into the inguinal position. |
Not in need of treatment. Regular control. At the end of puberty often permanent intrascrotal positioning, otherwise operative. |
Pendulum testis: Can be moved permanently into the scrotum. The testis "swings" back into the inguinal canal only occasionally. |
Ectopia testis |
Displacement of the testis outside the physiological descensus pathway, e.g. perineal, retroperitoneal. |
Surgical removal. |