Results of Treatment

  • John M. Hutson
  • Jørgen M. Thorup
  • Spencer W. Beasley


Operative success for cryptorchidism, defined as a testis permanently placed in the scrotum without atrophy, can be achieved for at least 90 % of testes that were originally distal to the external inguinal ring, for at least 85 % of ‘true’ inguinal (i.e. canalicular) testes and for approximately 80 % of intra-abdominal testes.There is good short-term evidence that early operation is likely to decrease the risk of the two major long-term sequelae: infertility and malignancy. However, there is little long-term evidence yet of improved prognosis for fertility and malignancy risk because of the length of time between initial treatment and ultimate result (i.e. 20 years for fertility and 30–40 years for malignancy).Nevertheless, the improved short-term outcomes for early orchidopexy less than 1 year of age suggests that further improved results should be seen in future years, as more patients having orchidopexy in early infancy reach adulthood.


Testicular Cancer Sperm Density Germ Cell Cancer Total Sperm Count Cryptorchid Testis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Thorup J, Haugen S, Kollin C, et al. Surgical treatment of undescended testes. Acta Paediatr. 2007;96(5):631–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Clarnette TD, Rowe D, Hasthorpe S, et al. Incomplete disappearance of the processus vaginalis as a cause of ascending testis. J Urol. 1997;157(5):1889–91.PubMedCrossRefGoogle Scholar
  3. 3.
    Hadziselimovic F, Herzog B. The importance of both an early orchidopexy and germ cell maturation for fertility. Lancet. 2001;358(9288):1156–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Capello SA, Giorgi Jr LJ, Kogan BA. Orchiopexy practice patterns in New York State from 1984 to 2002. J Urol. 2006;176(3):1180–3.PubMedCrossRefGoogle Scholar
  5. 5.
    Taran I, Elder JS. Results of orchiopexy for the undescended testis. World J Urol. 2006;24(3):231–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Docimo SG. The results of surgical therapy for cryptorchidism: a literature review and analysis. J Urol. 1995;154(3):1148–52.PubMedCrossRefGoogle Scholar
  7. 7.
    Meij-deVries A, van der Voort LM, Sijstermans K, et al. Natural course of undescended testes after inguinoscrotal surgery. J Pediatr Surg. 2013;48(12):2540–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Elyas R, Guerra LA, Pike J, et al. Is staging beneficial for Fowler-Stephens orchiopexy? A systematic review. J Urol. 2010;183(5):2012–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Kollin C, Hesser U, Ritzen EM, et al. Testicular growth from birth to two years of age, and the effect of orchidopexy at age nine months: a randomized, controlled study. Acta Paediatr. 2006;95(3):318–24.PubMedCrossRefGoogle Scholar
  10. 10.
    Thorup J, Jensen CL, Langballe O, et al. The challenge of early surgery for cryptorchidism. Scand J Urol Nephrol. 2011;45(3):184–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Ein SH, Nasr A, Wales PW, et al. Testicular atrophy after attempted pediatric orchidopexy for true undescended testis. J Pediatr Surg. 2014;49(2):317–22.PubMedCrossRefGoogle Scholar
  12. 12.
    Carson JS, Cusick R, Mercer A, et al. Undescended testes: does age at orchiopexy affect survival of the testis? J Pediatr Surg. 2014;49(5):770–3.PubMedCrossRefGoogle Scholar
  13. 13.
    McIntosh LA, Scrimgeour D, Youngson GG, et al. The risk of failure after primary orchidopexy: an 18 year review. J Pediatr Urol. 2013;9(6 Pt A):759–62.PubMedCrossRefGoogle Scholar
  14. 14.
    Nilsson R, Omland H, Dahl AA, et al. Early outcome of orchiopexy and analysis of predictive factors: a retrospective study from 2001 to 2010 in a Norwegian regional hospital. Scand J Urol. 2014;48(5):474–81.PubMedCrossRefGoogle Scholar
  15. 15.
    Cortes D, Thorup JM, Lindenberg S. Fertility potential after unilateral orchiopexy: an age independent risk of subsequent infertility when biopsies at surgery lack germ cells. J Urol. 1996;156(1):217–20.PubMedCrossRefGoogle Scholar
  16. 16.
    Rasmussen TB, Ingerslev HJ, Hostrup H. Natural history of the maldescended testis. Horm Res. 1988;30(4–5):164–6.PubMedCrossRefGoogle Scholar
  17. 17.
    Werder EA, Illig R, Torresani T, et al. Gonadal function in young adults after surgical treatment of cryptorchidism. Br Med J. 1976;2(6048):1357–9.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Cortes D. Cryptorchidism – aspects of pathogenesis, histology and treatment. Scand J Urol Nephrol Suppl. 1998;196:1–54.PubMedGoogle Scholar
  19. 19.
    Hadziselimovic F, Hoecht B. Testicular histology related to fertility outcome and postpubertal hormone status in cryptorchidism. Klin Pediatr. 2008;220(5):302–7.Google Scholar
  20. 20.
    Hadziselimovic F, Hecker E, Herzog B. The value of testicular biopsy in cryptorchidism. Urol Res. 1984;12(3):171–4.PubMedCrossRefGoogle Scholar
  21. 21.
    Cortes D, Thorup JM, Visfeldt J. Cryptorchidism: aspects of fertility and neoplasms. A study including data of 1,335 consecutive boys who underwent testicular biopsy simultaneously with surgery for cryptorchidism. Horm Res. 2001;55(1):21–7.PubMedCrossRefGoogle Scholar
  22. 22.
    Gill B, Kogan S, Starr S, et al. Significance of epididymal and ductal anomalies associated with testicular maldescent. J Urol. 1989;142(2 Pt 2):556–8. discussion 572.PubMedGoogle Scholar
  23. 23.
    Mollaeian M, Mehrabi V, Elahi B. Significance of epididymal and ductal anomalies associated with undescended testis: study in 652 cases. Urology. 1994;43(6):857–60.PubMedCrossRefGoogle Scholar
  24. 24.
    AbouZeid AA, Mousa MH, Soliman HA, et al. Intra-abdominal testis: histological alterations and significance of biopsy. J Urol. 2011;185(1):269–74.PubMedCrossRefGoogle Scholar
  25. 25.
    Lee PA, Coughlin MT. Fertility after bilateral cryptorchidism. Evaluation by paternity, hormone, and semen data. Horm Res. 2001;55(1):28–32.PubMedCrossRefGoogle Scholar
  26. 26.
    Cortes D, Thorup JM, Beck BL, et al. Cryptorchidism as a caudal developmental field defect. A new description of cryptorchidism associated with malformations and dysplasias of the kidneys, the ureters and the spine from T10 to S5. APMIS. 1998;106(10):953–8.PubMedCrossRefGoogle Scholar
  27. 27.
    Taskinen S, Hovatta O, Wikstrom S. Early treatment of cryptorchidism, semen quality and testicular endocrinology. J Urol. 1996;156(1):82–4.PubMedCrossRefGoogle Scholar
  28. 28.
    Engeler DS, Hosli PO, John H, et al. Early orchiopexy: prepubertal intratubular germ cell neoplasia and fertility outcome. Urology. 2000;56(1):144–8.PubMedCrossRefGoogle Scholar
  29. 29.
    Feyles F, Peiretti V, Mussa A, et al. Improved sperm count and motility in young men surgically treated for cryptorchidism in the first year of life. Eur J Pediatr Surg. 2014;24(5):376–80.PubMedGoogle Scholar
  30. 30.
    Cortes D, Thorup J, Lindenberg S, et al. Infertility despite surgery for cryptorchidism in childhood can be classified by patients with normal or elevated follicle-stimulating hormone and identified at orchidopexy. BJU Int. 2003;91(7):670–4.PubMedCrossRefGoogle Scholar
  31. 31.
    Thorup J, Cortes D, Petersen BL. The incidence of bilateral cryptorchidism is increased and the fertility potential is reduced in sons born to mothers who have smoked during pregnancy. J Urol. 2006;176(2):734–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Storgaard L, Bonde JP, Ernst E, et al. Does smoking during pregnancy affect sons’ sperm counts? Epidemiology. 2003;14(3):278–86.PubMedGoogle Scholar
  33. 33.
    Jensen TK, Jorgensen N, Punab M, et al. Association of in utero exposure to maternal smoking with reduced semen quality and testis size in adulthood: a cross-sectional study of 1,770 young men from the general population in five European countries. Am J Epidemiol. 2004;159(1):49–58.PubMedCrossRefGoogle Scholar
  34. 34.
    Lee PA, O’Leary LA, Songer NJ, et al. Paternity after unilateral cryptorchidism: a controlled study. Pediatrics. 1996;98(4 Pt 1):676–9.PubMedGoogle Scholar
  35. 35.
    Kraft KH, Canning DA, Snyder 3rd HM, et al. Undescended testis histology correlation with adult hormone levels and semen analysis. J Urol. 2012;188(4 Suppl):1429–35.PubMedCrossRefGoogle Scholar
  36. 36.
    Quinn FM. Evaluation of the scrotal testis before and after orchidopexy in experimental unilateral cryptorchidism. J Pediatr Surg. 1991;26(5):602–6.PubMedCrossRefGoogle Scholar
  37. 37.
    Agarwal PK, Diaz M, Elder JS. Retractile testis – is it really a normal variant? J Urol. 2006;175(4):1496–9.PubMedCrossRefGoogle Scholar
  38. 38.
    van Brakel J, Kranse R, de Muinck Keizer-Schrama SM, et al. Fertility potential in a cohort of 65 men with previously acquired undescended testes. J Pediatr Surg. 2014;49(4):599–605.PubMedCrossRefGoogle Scholar
  39. 39.
    Dieckmann KP, Pichlmeier U. Clinical epidemiology of testicular germ cell tumors. World J Urol. 2004;22(1):2–14.PubMedCrossRefGoogle Scholar
  40. 40.
    Manecksha RP, Fitzpatrick JM. Epidemiology of testicular cancer. BJU Int. 2009;104(9 Pt B):1329–33.PubMedCrossRefGoogle Scholar
  41. 41.
    Moller H. Epidemiological studies of testicular germ cell cancer. London: Kings College; 2001.Google Scholar
  42. 42.
    Pike MC, Chilvers C, Peckham MJ. Effect of age at orchidopexy on risk of testicular cancer. Lancet. 1986;1(8492):1246–8.PubMedCrossRefGoogle Scholar
  43. 43.
    Whitaker RH. Neoplasia in cryptorchid men. Semin Urol. 1988;6(2):107–9.PubMedGoogle Scholar
  44. 44.
    Petersen PM, Giwercman A, Hansen SW, et al. Impaired testicular function in patients with carcinoma-in-situ of the testis. J Clin Oncol. 1999;17(1):173–9.PubMedGoogle Scholar
  45. 45.
    Giwercman A, Grindsted J, Hansen B, et al. Testicular cancer risk in boys with maldescended testis: a cohort study. J Urol. 1987;138(5):1214–6.PubMedGoogle Scholar
  46. 46.
    Soltanghoraee H, Pourkeramati F, Khoddami M, et al. Prevalence of carcinoma in situ in testicular biopsies of infertile Iranian men. Andrologia. 2014;46(7):726–30.PubMedCrossRefGoogle Scholar
  47. 47.
    Walsh TJ, Dall’Era MA, Croughan MS, et al. Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. J Urol. 2007;178(4 Pt 1):1440–6. discussion 1446.PubMedCrossRefGoogle Scholar
  48. 48.
    Pettersson A, Richiardi L, Nordenskjold A, et al. Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med. 2007;356(18):1835–41.PubMedCrossRefGoogle Scholar
  49. 49.
    Swerdlow AJ, Higgins CD, Pike MC. Risk of testicular cancer in cohort of boys with cryptorchidism. BMJ. 1997;314(7093):1507–11.PubMedCentralPubMedCrossRefGoogle Scholar
  50. 50.
    Puri P, O’Donnell, B. Semen analysis of patients who had orchidopexy at or after seven years of age. Lancet, 2(8619):1051–2.Google Scholar
  51. 51.
    Singer R, Dickerman Z, Sagiv M, Laron Z, Livni E. Endocrinological parameters and cell-mediated immunity postoperation for cryptorchidism. Arch Androl. 1988; 20(2):153–7.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • John M. Hutson
    • 1
  • Jørgen M. Thorup
    • 2
  • Spencer W. Beasley
    • 3
  1. 1.Royal Children’s Hospital University of MelbourneParkvilleAustralia
  2. 2.Univ. Hospital of Copenhagen RigshospitaletKøbenhavnDenmark
  3. 3.University of OtagoChristchurchNew Zealand

Personalised recommendations