"Cryptorchidism is usually diagnosed in infancy or early childhood on clinical examination when one or both hemiscrota appear empty or underdeveloped. Most testes that will spontaneously descend do so within the first 3–6 months of life; descent after 6 months is uncommon. The undescended testis is often palpable in the inguinal canal or suprascrotal region, but may be non‑palpable if intra‑abdominal, very small, or absent 4,8,11."
"Ultrasound is usually the first‑line imaging modality and has moderate sensitivity and high specificity for localising undescended testes, with better performance for inguinal/palpable testes and poorer performance for intra‑abdominal non‑palpable testes. Reported sensitivities vary widely (approximately 45–80% depending on cohort and testis location), and a negative ultrasound does not reliably exclude an intra‑abdominal testis 4,14."
"MRI is the preferred cross‑sectional imaging modality when advanced imaging is required, particularly for non‑palpable testes where ultrasound is inconclusive and prior to or instead of immediate diagnostic laparoscopy in selected cases 11,13. MRI (especially with DWI or chemical‑shift techniques) has higher sensitivity than ultrasound and very high specificity, but the point estimates vary: e.g. sensitivity 82–93%, specificity 79–100%, accuracy ~82–91%. 14-16."
"MRI is the preferred cross‑sectional imaging modality when advanced imaging is required, particularly for non‑palpable testes where ultrasound is inconclusive and prior to or instead of immediate diagnostic laparoscopy in selected cases 11,13. MRI (especially with DWI or chemical‑shift techniques) has higher sensitivity than ultrasound and very high specificity, but the point estimates vary: e.g. sensitivity 82–93%, specificity 79–100%, accuracy ~82–91%. 14-16."
"MRI is the preferred cross‑sectional imaging modality when advanced imaging is required, particularly for non‑palpable testes where ultrasound is inconclusive and prior to or instead of immediate diagnostic laparoscopy in selected cases 11,13. MRI (especially with DWI or chemical‑shift techniques) has higher sensitivity than ultrasound and very high specificity, but the point estimates vary: e.g. sensitivity 82–93%, specificity 79–100%, accuracy ~82–91%. 14-16."
"T1: intermediate signal intensity"
"T2: high signal intensity, similar to a normal testis"
"non‑palpable testis: diagnostic and therapeutic laparoscopy to localise the testis, assess its size and vascular pedicle, and perform laparoscopic orchiopexy or orchidectomy if the testis is severely atrophic or intra‑abdominal with unfavourable vessels. Laparoscopy is now considered the gold standard for evaluation of a non‑palpable testis, as it provides direct visualisation of intra‑abdominal structures and allows definitive management in the same setting 11,12."
Expected headings
"Locations"
"Technique"
"Protocol"
"Surgical approach"
"Complications"
"Cryptorchidism is the most common congenital anomaly of the male genitalia 11. Undescended testes are present in approximately 3% of term male newborns and up to 30% of preterm male infants; by 1 year of age, spontaneous descent has reduced the prevalence to about 1% 11,13."
"The condition is usually unilateral and more often affects the right testis; bilateral cryptorchidism accounts for around 10% of cases 11."
"Cryptorchidism is usually diagnosed in infancy or early childhood on clinical examination when one or both hemiscrota appear empty or underdeveloped. Most testes that will spontaneously descend do so within the first 3–6 months of life; descent after 6 months is uncommon. The undescended testis is often palpable in the inguinal canal or suprascrotal region, but may be non‑palpable if intra‑abdominal, very small, or absent 4,8,11."
"more challenging to visualise; may appear as a small, hypoechoic structure near the internal ring or along the iliac vessels, often with a limited acoustic window due to bowel gas 4,14"
"can usually be manipulated into the scrotum where it remains temporarily; monitoring is recommended as some cases ascend over time"
"Long‑term follow‑up may include periodic clinical examinations, education on testicular self‑examination, and, in some settings, fertility assessment in adulthood, particularly for bilateral cryptorchidism or delayed correction 11,12."
"From an imaging standpoint, inguinal lymph nodes, hernia sacs, epididymal or paratesticular cysts and small atrophic remnants can mimic an undescended testis on ultrasound or MRI, and correlation with surgical findings remains the gold standard in equivocal cases 14."