Chapter 86 The Testis and Scrotum

The incidence of testicular maldescent at the age of 1 year is around 1%. The condition is sometimes missed in the neonatal period and only discovered later in life. The presence of a hernia, testicular pain or acute torsion may direct attention to the abnormality. Cryptorchidism occurs in approximately 1.5–4% of fathers and 6% of brothers of individuals with cryptorchidism. The condition is more common on the right and is bilateral in 20% of cases. In adults, secondary sexual characteristics are typically normal. The infertility rate for unilateral cases is not believed to be very different from the general population. The important differential diagnosis is the so-called ‘retractile testis’. During childhood the testes are mobile and the cremasteric reflex is active, so that, in some boys, any stimulation of the skin of the scrotum or thigh causes the testis to ascend and to temporarily disappear into the inguinal canal.

Advanced Learning Content
Chapter 86: The Testis and Scrotum
Multiple Choice Questions
Weblinks

Journal articles

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000479.pub6/full/ (free)

A Cochrane systematic review evaluating the effect of varicocele treatment on live birth and pregnancy rate in subfertile couples where the male has a varicocele. Despite the heterogeneity of data, there is an increase in successful outcomes after treating clinical varicoceles.

https://static1.squarespace.com/static/5c4498eeaa49a13f3137ee64/t/5c6c11bb085229f28786151c/1550586300939/Kulkarni+Sperm+retrieval+in+KS.pdf/ (free)

Link to an e-learning module on the impact and management of infertility in patients with Klinefelter syndrome, one of the most common known genetic causes of male subfertility.

Guidelines

https://uroweb.org/guidelines/testicular-cancer/

Link to the European Association Urology guidelines on the diagnosis and management of testicular tumours with the latest versions uploaded to this site based on current evidence.

https://www.auanet.org//guidelines-and-quality/guidelines/urotrauma-guideline

The American Urological Association guidelines on urogenital trauma, with sections on scrotal/testicular trauma and management. Emphasises the need for prompt surgical exploration in severe trauma.

https://uroweb.org/guidelines/urological-trauma/chapter/urogenital-trauma-guidelines

The European Association Urology guidelines on urogenital trauma, with sections on scrotal/testicular trauma and management. Emphasises the need for prompt surgical exploration in severe trauma.

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