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The first 25 slides, exactly as they appear. The full deck has 72 content slides.
Paediatric Surgery
Cryptorchidism
Built from Puri — Pediatric Surgery and Pediatric Urology
What’s inside
11 sections · 72 slides
Overview
- What you will learn
The problem in plain terms
What cryptorchidism is and why it matters
- What is an undescended testis?
- Why the scrotum matters: it is a cooler bag
- Two harms follow if the testis stays warm
- Cryptorchidism by the numbers
How a normal testis descends
The two-phase journey before birth
- It all starts with the sex-determining switch
- Meet the gubernaculum: the guide-rope
- The processus vaginalis: a peritoneal finger
- The path of testicular descent
- Phase 1 — the transabdominal move (INSL3-driven)
- Phase 2 — the inguinoscrotal move (androgen-driven)
- How the testis knows which way to go
- Arrival and sealing the door
- After birth: 'minipuberty' matures the germ cells
- Germ-cell maturation after birth
Types of undescended testis
Congenital, acquired, and the mimics
- The basic split: congenital vs acquired
- Congenital UDT: palpable vs impalpable
- Ectopic and late-descending testes
- The story of acquired UDT
- Congenital vs acquired at a glance
Why descent fails
The causes and risk factors
- Causes are multifactorial
- Hormone-signalling anomalies
- Risk factors for cryptorchidism (Gurney et al. 2017)
- What causes the acquired type
The damage cryptorchidism does
Fertility and cancer
- Heat is the enemy of sperm production
- From heat to cancer
- The cancer signal
Finding the testis
Clinical examination and diagnosis
- What a cryptorchid testis feels like
- Confirming and timing the diagnosis
- Screening for the acquired type
Deciding treatment
Timing, hormones, and the operative options
- The goal and the timing
- Do hormones help?
- Three operative routes
- The Fowler–Stephens principle
The operation step by step
Open inguinal orchidopexy and the laparoscopic approach
- Setup for open orchidopexy
- Inguinal skin-crease incision
- Opening the inguinal canal
- Mobilising the spermatic cord
- Isolating the processus vaginalis
- Reaching the internal inguinal ring
- Anatomy before high ligation
- Making a tunnel to the scrotum
- Creating the subcutaneous scrotal pouch
- Delivering the testis into the pouch
- Closing the wounds
- Laparoscopy for the impalpable testis
- Laparoscopy port sites
- Laparoscopic orchidopexy
- Fowler–Stephens, first stage
- Fowler–Stephens, second stage
What to expect afterwards
Success, cancer and fertility outcomes
- How well surgery works
- Cancer risk after orchidopexy — read carefully
- Fertility outcomes
- Outcome snapshot
Conclusion
Where things stand and where they are heading
- The big picture
- Viva: Why is 6–12 months the target age for orchidopexy?
- References (1/4)
- References (2/4)
- References (3/4)
- References (4/4)
- Pediatric Surgery and Pediatric Urology