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February 25, 1956


JAMA. 1956;160(8):634-641. doi:10.1001/jama.1956.02960430024005

• True cryptorchism must be distinguished from high retracted testis, which is normal in some boys up to the age of puberty. In true cryptorchism the testis cannot be palpated or, if palpable, cannot be displaced into the scrotum.

An undescended testis can produce enough androgenic hormone to fulfill its endocrine function, but it is liable to mechanical injury and is unable to produce spermatozoa. The psychological need for correction is an important consideration. The evidence that such correction reduces the danger of subsequent malignancy is unconvincing.

Orchiopexy generally involves both the treatment of an indirect inquinal hernia and the repositioning of the testis. In this series of operations there has never been recurrence of the hernia. Operations of the Torek type for repositioning, whereby the testis is temporarily bound to the thigh, are likely to damage the blood supply and give very poor results. The operation here described involves freeing the ductus deferens down to the base of the bladder and the spermatic vessels well up to the inferior pole of the kidney so as to minimize all tension. It is done on one side at a time. The operation is best done between the ages of 9 and 11. In a group of patients studied 10 years or more after bilateral orchiopexy, 79% have been shown to be fertile.