Cryptorchidism: Causes and Consequences

Book excerpt: Cryptorchidism is the failure of one or both testes to descend into the scrotum at birth or shortly thereafter, depending on species, or the ascent of previously descended testes later in life. It is the commonest of all congenital conditions in the human representing between 1 and 9% of all male babies born. It is also common in domestic species such as pigs, dogs and horses. Importantly, cryptorchidism is seen as a sentinel of fetal well-being and is associated with other less common ailments such as testis cancer and hypospadias as part of the testicular dysgenesis syndrome (TDS), as well as being linked to maternal smoking and intrauterine growth restriction. It also likely results from maternal exposure to endocrine disrupting chemicals. Surprisingly, we know relatively little about its immediate causes although deficits in fetal hormonal signaling through INSL3 or testosterone and complex genetic susceptibility seem to be involved. The testes may be affected unilaterally or bilaterally with anatomical arrest anywhere between the abdomen to just above the scrotum. Significantly, we need to distinguish between the consequences of cryptorchidism simply due to retention of the testes within the body cavity at abdominal rather than scrotal temperature, and those sequelae which share a common fetal cause. The former are largely correctable by early orchidopexy. In this Research Topic we aim to bring together a broad selection of articles (reviews, original research articles, commentaries and hypotheses) from the leading experts in the field, discussing all aspects of this common congenital condition, and throwing light on its genetic and environmental causes including its relationship to TDS and the biological mechanisms involved, its sequelae, and how these relate to optimal treatment.