Associated Conditions with Undescended Testis
Inguinal hernia is the most common associated condition with undescended testis and represents a primary indication for surgical treatment. 1
Most Common Associated Anomaly
Inguinal hernia is explicitly identified by the American Urological Association guidelines as one of the main reasons for treatment of cryptorchidism, alongside increased risks of impaired fertility, testicular malignancy, and torsion. 2, 1 This association is so well-established that inguinal hernia is considered a key complication requiring intervention in primary cryptorchidism treatment guidelines. 1
- During physical examination of any boy with cryptorchidism, you must examine for an inguinal bulge or hernia. 1
- Research confirms that inguinal hernias are among the most common associated anomalies seen with undescended testis. 3
Hypospadias Association
Hypospadias is also documented as one of the most common associated anomalies with undescended testis. 3
- The observation that acquired cryptorchidism is more common in boys with a history of proximal hypospadias suggests a common mechanism, such as aberrant androgen signaling, may predispose to both anomalies. 2
- When unilateral or bilateral cryptorchidism is present with phallic anomalies such as hypospadias or micropenis, the possibility of disorders of sex development should be considered. 2
Congenital Heart Defects
There is no evidence linking isolated cryptorchidism with congenital heart defects according to the American Urological Association guidelines. 1 This makes congenital heart defect an incorrect association in the context of isolated undescended testis.
Clinical Pitfalls to Avoid
- Do not overlook examining for inguinal hernia during the physical examination of any child with undescended testis, as this is the most common associated condition. 1
- Be alert for hypospadias or other phallic anomalies, which may indicate aberrant androgen signaling or potential disorders of sex development requiring additional evaluation. 2, 3
- In cases of bilateral nonpalpable testes with phallic anomalies, immediately consult a specialist to evaluate for disorders of sex development before proceeding with circumcision. 2