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Introduction

Cryptorchidism, or undescended testis, is a congenital condition in which one or both testes fail to descend into the scrotum.  Untreated cryptorchidism increases the risk for testicular torsion, infertility, and testicular malignancy.

Pathophysiology

The testicles develop in the fetal abdomen during organogenesis.  Between 8 weeks and term gestation, each testis descends from the abdomen into the inguinal canal and then into the scrotum ( Figure 1).  The inguinal descent involves each testis progressing through the deep inguinal ring (an opening in the transversalis fascia) and entering the scrotum via the superficial inguinal ring, which is a physiologic opening in the external oblique aponeurosis.

Cryptorchidism is the failure of one or both testes to descend into the scrotum before birth.  Undescended testes may be unilateral (more common) or bilateral and can lie anywhere along the path from the abdomen to the scrotum.

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