Steven S. Shen, MD, PhD

Low-power photomicrograph shows cryptorchid testis with crowded seminiferous tubules, no spermatogenesis, and decreased tubular size. The interstitium is edematous image.

This photomicrograph from a cryptorchid testis shows seminiferous tubules image with no spermatogenesis and marked interstitial edema image. The tubules are lined only by Sertoli cells image.



  • Undescended testis


Developmental Anomaly

  • Idiopathic

  • Anomalies in anatomic development

  • Defect in fetal androgens or excess maternal estrogen

  • Possible common genetic abnormality causing undescended testis and predisposing to carcinoma of testis

  • Associated with congenital malformation syndromes such as Prader-Willi syndrome, Noonan syndrome, and cloacal exstrophy

Acquired Cryptorchidism

  • Postoperative trapped testis

  • Spontaneous ascent (idiopathic)



  • Incidence

    • Most common birth defect of male genitalia

    • 3% of full-term newborns have an undescended testis

    • 1% of infants have incompletely descended testes 12 months after birth

    • More common in premature infants (30% of boys born at 30 weeks gestational age)

    • True cryptorchidism accounts for 25% of cases of empty scrotum


  • No particular symptoms; empty scrotal sac usually detected by parents

  • About 2/3 unilateral and 1/3 bilateral

  • 90% may be palpable in inguinal canal (10% in abdomen or nonexistent, truly hidden, or anorchia)

  • May be found anywhere along “path of descent” from retroperitoneum to inguinal ring

  • Rarely located outside of “path of descent” (ectopic), such as in the perineum, opposite scrotum or femoral canal, under the skin, or outside the inguinal canal

Natural History

  • Predisposition to testicular germ cell neoplasia

    • Cryptorchidism increases risk of testicular cancer by 4-10x

    • Most common tumor in undescended testis is seminoma

    • Contralateral testis is primary site in 20% of cases

    • Orchiopexy facilitates self-examination and may decrease risk of germ cell tumor

  • Infertility

    • Most common problem caused by cryptorchidism

    • Tubular fertility index (number of germ cells per cross-sectioned tubule) is most important factor

    • 75-85% of cryptorchid males have sperm count below normal

    • Location and size of cryptorchid testis have no influence on fertility

  • Torsion

  • Psychological


Jul 8, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Cryptorchidism

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