Cryptorchidism and inguinal hernia

Cryptorchidism (ie undescended testes or testes not in the scrotum) is more common in hypogonadal males than in males with normal gonadal development. It is also associated with several developmental disability syndromes (eg Down syndrome, Prader-Willi syndrome, Noonan syndrome). Inguinal cryptorchidism carries a 4-fold lifetime increased risk of testicular cancer; the risk is higher for an intra-abdominal testis.

Refer for ultrasound if either testis cannot be identified.

If possible, the undescended testis should be brought into the scrotum (preferably before puberty) to allow routine regular surveillance. Intra-abdominal testes that cannot be brought down by orchidopexy should be removed.

Inguinal hernia may cause groin and abdominal pain in males with developmental disability. Consider inguinal hernia if the person presents with a change in behaviour or nonspecific pain behaviour. Strangulated hernia is a surgical emergency.