[Early diagnosis and correct treatment of cryptorchism].

Abstract

Diagnosis in cryptorchidism should be as early as possible for therapeutical purposes and for the achievement of most positive results. Early but also exact diagnosis allows a selective therapy concerning type of procedure and age of performance. Aims of early diagnosis and selected treatment are: prevention of infertility and eventual decrease of androgenic endocrinal function in the adult; prevention of torsion in retractile testis; prevention of trauma in perineal ectopic situation; prevention of cancer especially in cryptorchidism of the adult; prevention of psychogenic defects of the empty scrotum. Those goals can be obtained by different approaches: pharmacological (hormonal stimulation), surgical (orchidopexy) or by their association. If hormonal administration is not suitable or without results surgical approach will be adopted. Which is now the most suitable age for surgery? Testicular damages begin at the second year of life. Therefore operation should be acted in advance. However, up to date international acknowledgement is in favour of surgical management around the fourth year for the advantages of a more mature anatomical situation without reducing quality of results. Purpose of early diagnosis and selective therapy in cryptorchidism is to avoid irreversibility of severe histological alteration able to compromise gonadal, especially germinal, function. It is never to forget that the high level of infertility in cryptorchidism can be depending not only on evident alteration in number, motility and morphology of spermatozoa but also on morphofunctional defects escaping from the routine seminal examination. All that is in tight connection with the intrinsic dysmorphism in cryptorchism where the abnormal position of the testis is only a partial aspect.(ABSTRACT TRUNCATED AT 250 WORDS)