Testicles

CRYPTORCHIDISM - Situation in which the testis is neither visible nor palpable in the scrotum: Hypoplastic or absent testis, Undescended testis (testicular retention), Ectopic testis, Retractile testis, Secondary cryptorchidism. Often associated with an open processus vaginalis, can be cause of infertility, increased risk of testicular torsion and increased risk of malignant degeneration (tenfold increase). Diagnosis is clinical (+/- US scan and MRI). Treatment is either medical (HCG and/or GnRH - success rate 15-30%)) or surgical (Shoemaker's orchiopexy - 95% success; laparoscopy for abdominal testes). TESTICULAR / TESTICULAR APPENDAGES TORSION - The first suspicion in case of acute scrotum in childhood; risk increased in case of undescended testis or trauma; marked by sudden severe testicular pain, swelling of the testis, redness of the scrotum. Requires either immediate Doppler ultrasonography examination or operative inspection of the testis. VARICOCELE - Swelling of the plexus pampiniformis (mostly left, usually asymptomatic) raising the temperature in the scrotum, with consequent testicular damage. Can be treated by surgical ligature of the testicular vessels (open or laparoscopical)