Hypospadias is the Associated Condition Related to Sexual Development
The answer is A - Hypospadias. Unilateral undescended testis with absent scrotum on the affected side is part of testicular dysgenesis syndrome (TDS), and hypospadias is the primary associated condition related to sexual development within this syndrome 1.
Understanding Testicular Dysgenesis Syndrome
Cryptorchidism (undescended testis) is postulated to be part of testicular dysgenesis syndrome (TDS), which is a developmental disorder of the gonads caused by environmental and/or genetic influences early in pregnancy, including exposure to endocrine-disrupting chemicals 1.
TDS specifically includes the following components related to sexual development:
- Cryptorchidism (undescended testis) 1
- Hypospadias 1
- Lower fertility 1
- Higher risk of malignancy 1
- Dysfunction of Leydig/Sertoli cells 1
Why the Other Options Are Incorrect
Inguinal Hernia (Option B)
While inguinal hernias can occur with undescended testis due to the patent processus vaginalis, this is a mechanical association rather than a disorder of sexual development 2, 3. Inguinal hernias are not part of the testicular dysgenesis syndrome constellation.
Pyloric Stenosis (Option C)
Pyloric stenosis is a gastrointestinal condition with no relationship to sexual development or testicular dysgenesis syndrome. This is completely unrelated to cryptorchidism.
Congenital Heart Disease (Option D)
Congenital heart disease is not associated with isolated cryptorchidism or testicular dysgenesis syndrome. While it may occur in certain syndromic conditions, it is not a disorder of sexual development.
Clinical Significance
The presence of unilateral undescended testis with absent scrotum should prompt evaluation for hypospadias and other features of TDS 1. This combination suggests a more significant underlying disorder of gonadal development rather than isolated cryptorchidism.
Important Clinical Considerations:
- Even unilateral cryptorchidism can affect the contralateral descended testis, with structural abnormalities including smaller volume, softer consistency, and lower markers of future fertility potential 1
- Patients with TDS have higher risks of infertility, testicular cancer (3.6-7.4 times higher than general population), and hypogonadism 1
- Surgical correction (orchidopexy) should be performed by 18 months of age to maximize fertility potential and potentially reduce cancer risk 4, 2