Editing AUA: Cryptorchidism (2018)

'''See [https://pubmed.ncbi.nlm.nih.gov/24857650/ Original Guidelines]'''

* Literature search up to October 2018

== Definitions ==

* '''Cryptorchidism, or undescended testis (UDT): failure of a testis to descend into a scrotal position'''
** '''Classified as congenital vs. acquired'''
*** '''Congenital cryptorchidism: testes that are extrascrotal from the time of birth'''
*** '''Acquired cryptorchidism:  testes are intrascrotal at birth but subsequently identified in an extrascrotal position'''
**** Classified as ascending vs. entrapped
***** Ascending: spontaneous change from an intrascrotal to an extrascrotal position occurs at some point after birth
***** Entrapped: change from an intrascrotal to an extrascrotal position occurs after prior inguinal surgery
** '''Retractile testis: testis that is initially extrascrotal on examination or moves easily out of scrotal position, (often associated with a vigorous cremasteric reflex), but that can be manually replaced in stable, dependent scrotal position and remain there without tension at least temporarily'''
* Atrophic testis: testis that suffers significant volume loss due to
*# Prior inguinal or testicular surgery OR
*# Due to prolonged location in an extrascrotal position OR
*# Primary developmental failure
* '''Vanished testis: testis was present initially but disappeared during development most likely due to spermatic cord torsion or vascular accident.'''

== Background ==

* Epidemiology
** Most common genital disorder identified at birth

== Diagnosis and Evaluation ==
'''Cryptorchid testes may be (4):'''

* '''Prescrotal (above or at the scrotal inlet),''' 
* '''In the superficial inguinal pouch (distal and lateral to the external inguinal ring, anterior to the rectus muscle), at the external ring (or prepubic),''' 
* '''Within the inguinal canal'''
* '''Ectopic''' 
** '''Most commonly perineal'''
** '''Abdominal''' 
*** "Peeping" through or proximal to the internal inguinal ring
*** Near the bladder, iliac vessels or kidney

== Management ==

* '''Reasons for treatment'''
*# '''Increased risks of impairment of fertility potential'''
*# '''Testicular malignancy'''
*# '''Torsion'''
*# '''Associated inguinal hernia'''
* Orchidopexy/orchiopexy 
** Current standard of therapy in the United States
** Refers to surgical repositioning of the testis within the scrotal sac

== Questions ==

== Answers ==

== References ==

* Kolon, Thomas F., et al. "Evaluation and treatment of cryptorchidism: AUA guideline." ''The Journal of urology'' 192.2 (2014): 337-345.