[Cryptorchidism: the point of view of a pediatric urologist]

Abstract

Cryptorchidism is a very common anomaly of testicular migration, different from ectopy, anorchidy or retractile testis. Physiopathology of cryptorchidism is now well known. Hypogonadotrophic hypogonadism during pregnancy is mostly admitted. Recent epidemiologic studies show a significant increase due to toxic environmental factors, in particular pesticide. Cryptorchidism is most often isolated but polymalformatives entities must be eliminated, requiring sometimes hormonal or genetic investigations. Diagnosis is firstly clinical but coelioscopy adds accuracy and fiability. Infertility and cancer are the two majors risks of cryptorchidism, but their physiopathological mechanisms are still debated. It is not yet clear, in particular as far as the risk of infertility is concerned, if the testicular damage is primitive or (and) deteriorates with age. Medical and surgical treatments are now rather well codified. If, so far, there is no consensus about the age of management of cryptorchidism, many data of the literature lead pediatric urologists to manage these boys as soon as they are two or three.