Migration of the developing testis to and through the internal inguinal ring is at least partly dependent on the development of elevated intra-abdominal pressure by the abdominal musculature. Without this pressure, the processus vaginalis may not extend into the scrotum and the testis will not be pushed into the inguinal canal. Cryptorchidism occurs in all boys with the Prune Belly Syndrome (lax abdominal wall musculature) and it is more common in boys born with abdominal wall defects that result in a decrease in intra-abdominal pressure (gastroschesis, oomphalocele).
Diagnosis: Examination of a newborn will demonstrate any abdominal wall defects. Many of these boys will have non-palpable gonads present in the abdominal cavity.
Treatment: Orchiopexy (the surgery to bring the testis into the
scrotum). This surgery may require a relatively extensive dissection
in the retroperitoneum to locate and mobilize the testis.
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©David A. Hatch, M.D., 1996