Congenital anomalies of the testes

Cryptorchidism

Cryptorchidism is the failure of one or both testicles to descend into scrotum. Untreated, it increases the risk for testicular cancer, infertility, and testicular torsion.

• 1% of boys
  • It’s the most common congenital anomaly of genitourinary tract
• Risk factors
  • Prematurity
• Diagnosis
  • Testis cannot be palpated in the scrotum
• Treatment
  • Many spontaneously descent, but not after 6 months
  • Within 6 – 18 months
  • Orchidopexy
  • Laparoscopic surgery

Congenital hydrocele

Congenital hydrocoele is a fluid collection between the layers of the tunica vaginalis.

• Causes painless, enlarged scrotum
• Usually resolves spontaneously
• Requires surgery if it persists beyond 12 months

Ectopic testes

• Testes is located outside the normal path of descent
• Increases risk of cancer and infertility
• In superficial inguinal pouch, perineum, femoral canal, suprapubic region
• Treatment is orchidopexy

Congenital varicocoele

Varicocoele, the abnormal enlargement of the pampiniform plexus in the scrotum due to obstruction of the spermatic vein, can be congenital/primary. It almost always affects the left testicle. It's an under-recognised cause of male infertility. It causes pain in the affected testicle and painless swelling. Surgery may be indicated in case of pain or infertility.