What other conditions may be associated with a pediatric case presenting with undescended left testis and underdeveloped left scrotum, such as Hypospadias (a condition where the urethra opens on the underside of the penis), Inguinal (abdominal wall) hernia, or Congenital heart defects?

Associated Conditions with Undescended Testis

The correct answer is B - Inguinal hernia, which is the most common associated anomaly with undescended testis and represents a key reason for treatment of cryptorchidism. 1

Most Common Associated Conditions

Inguinal hernia is explicitly identified as one of the main reasons for treatment of cryptorchidism in the American Urological Association guidelines, alongside increased risks of impaired fertility, testicular malignancy, and torsion. 1

Evidence for Inguinal Hernia Association

• Inguinal hernias are among the most common associated anomalies seen with undescended testis. 2
• The AUA guidelines specifically list "associated inguinal hernia" as one of the primary treatment indications for cryptorchidism. 1

Evidence for Hypospadias Association

• Hypospadias is also a commonly associated anomaly with undescended testis. 2
• Boys with proximal hypospadias have a significantly higher incidence of both congenital cryptorchidism (p = 0.03) and acquired undescended testes (p = 0.001) compared to boys with other types of hypospadias. 3
• Cryptorchidism and inguinal hernia are the most common associated anomalies with hypospadias. 4
• The frequency of associated anomalies increases with the severity of hypospadias. 4

Clinical Implications

Both inguinal hernia (Option B) and hypospadias (Option A) are well-documented associations with undescended testis, but inguinal hernia is more directly emphasized in the primary cryptorchidism treatment guidelines as a key complication requiring intervention. 1, 2

What to Look For

• Examine for inguinal bulge or hernia during physical examination of any boy with cryptorchidism. 1
• Assess the urethral meatus position to identify hypospadias. 2, 4
• The severity of hypospadias correlates with higher rates of associated cryptorchidism. 3

Congenital Heart Defects

There is no evidence in the provided guidelines or research linking isolated cryptorchidism with congenital heart defects (Option D). 1 This association would be more relevant in syndromic cases, which are beyond the scope of isolated cryptorchidism management. 1