Editing Undescended Testicle (section)

== Rationale for treatment ==

* '''Surgical correction is offered early after diagnosis'''
* '''<span style="color:#ff0000">Long-term complicated of untreated UDT</span>'''
*# '''<span style="color:#ff0000">Hypogonadism</span>'''
*# '''<span style="color:#ff0000">Reduced fertility</span>'''
*#* Sperm counts are reduced in > 25% of formerly unilateral and the majority of formerly bilateral cryptorchid men
*#* '''Paternity rates are largely unchanged for men with unilateral cryptorchidism compared to the general population''' (≈90%), '''but are significantly lower (33‒65%) for those with bilateral UDT'''
*#* '''Both location and time of UDT correlate with Leydig and germ cell loss.'''
*#** '''Intra-abdominal/non-palpable testes depict severe germ cell loss, as do testes that remain undescended by age 2'''
*# '''<span style="color:#ff0000">Risk of testicular cancer</span>'''
*#* '''Relative risk (RR) of UDT: 2.75‒8x; risk is slightly increased also in the normally descended testis.'''
*#* '''Performing orchiopexy prior to puberty appears to decrease the RR of subsequent testicular cancer to 2.23, but it still remains above that of the normal non-cryptorchid male'''
*#* '''Pathology'''
*#** '''Persistent (untreated) UDT: seminoma more likely (74%)'''
*#** '''Scrotal (treated) testis: non-seminoma more likely (63%)'''
*#* '''The risk of benign testicular tumours (e.g. mature teratoma) is not increased with cryptorchidism'''
* '''<span style="color:#ff0000">Goals of treatment</span>'''
*# '''<span style="color:#ff0000">Maximize chances of adequate hormone production and future fertility potential</span>''' by preventing acquired/progressive damage
*# '''<span style="color:#ff0000">Prevent testicular torsion</span>'''
*# '''<span style="color:#ff0000">Locate testicle(s) in a position amenable to self-exam</span>''' (or caretaker/healthcare provider regular assessment in patients unable to reliably conduct self-examination) which aids in early diagnosis of testicular cancer
*# '''<span style="color:#ff0000">Treat associated conditions, such a patent processus vaginalis/inguinal hernia</span>'''
*# Avoid missing viable gonadal tissue in an abnormal location (most important intra-abdominal), as it could lead to delayed diagnosis of '''testicular neoplasm'''
*# Relocate all viable gonad(s) in scrotum to maximize '''psychological benefits of normal anatomy'''
*# '''<span style="color:#ff0000">Prevent direct testicular trauma</span>''' against the pelvic bones during intercourse or sports
*# '''Avoid unnecessary imaging studies'''
*# '''Minimize parental anxiety'''