Testicle: cryptorchidism

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Introduction

  • Cause : heritable failure of normal testicular descent.
  • Incidence: 1-15% of males.
  • Signs : may be none except absence of testicles in scrotum, or signs related to secondary complications of retention.
  • Diagnosis : imaging or indentification at laparotomy.
  • Treatment : bilateral orchidectomy.
  • Prognosis : significantly increased risk of testicular neoplasia, (particularly Sertoli cell tumors).
  • If intra-abdominal, increased risk of testicular torsion.
    Print off the owner factsheet Cryptorchidism in the dog (retained testicle) to give to your client.

Diagnosis

Clinical signs

  • Absence of one or both testicles in scrotum.
    Diagnosis may be complicated by incomplete history pertaining to neutering
  • Palpable abdominal mass.
  • Signs associated with abdominal mass.
  • Feminization or pancytopenia if hyperfunctional sertoli cell tumor present.
  • Testicular torsion presents as an acute abdominal pain and large, turgid, moveable abdominal mass. Affected dogs may present in shock.

Differential diagnosis

  • Intersex abnormality with bilateral retained testes and XX phenotype. Well known in some breeds, eg Spaniel.
  • Previous unrecorded castration.
  • Incomplete castration, ie removal of one intra-abdominal testes while scrotal testicle in situ.

Outcomes

Prognosis

  • Good overall.
  • Significantly increased risk of testicular tumor, especially Sertoli cell, (most are benign).
  • Larger testicles usually neoplastic - always perform histopathology.
  • Stable animals with torsed testicles usually recover uneventfully after testicle removal.

Reasons for treatment failure

  • Failure to find/remove ectopic testicle.
  • Poor ligation security → hemorrhage.
  • Failure to determine severe systemic effect of hyperestrogenism from Sertoli cell tumor.
  • Metastasis from malignant testis (rare).
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