Treatment of Undescended Testicles

As background, undescended testicles are relatively common birth defects, with or without CdLS. Usually with CdLS, we see both testicles undescended, or bilateral cryptorchidism. Most of the time the testicles are present, but just have not come down from the abdomen or the canal in between the abdomen and the scrotum. There are risks associated with not bringing them down: infertility (which may or may not be an issue in CdLS depending on the level of involvement), risk for developing testicular cancer (which is ten times higher if testicles are left in the abdomen and much reduced if the testicles are brought down), hernias and twisting of the testicle and cutting off of the blood supply which could lead to complications. So, generally, it is advised to bring the testicles down. This is performed surgically, ideally between 9 and 15 months of age. Subsequent to surgery, the testicle has to be monitored every six to twelve months to make sure it does not go back in. If it rises just into the canal, but it can be palpated (felt), then there is no increased risk.

If the testicles cannot be palpated initially, then the surgeon will often recommend going into the abdomen and looking with a laparoscopy to make sure the testicle is there. If the testicle, when it is found, appears to be abnormal (smaller than it should be, wrinkled or withered) then the surgeon would most likely remove it so as not to put the patient at any increased risk of cancer. The location of the testicle should not change management.

TK 7-13-10