title: Alternatives to orchiopexy.
abstract: With improved surgical techniques orchiopexy has become possible in patients with cryptorchidism who previously were forced to alternatives, including no treatment at all, a trial of hormonal therapy or orchiectomy. However, the mere presence of a testis in the scrotum may not benefit some patients, that is neither enhancing fertility nor reducing malignancy. A prosthesis may provide comparable appearance and psychologic support. No treatment is indicated in cases of severe mental retardation, ejaculatory failure (as with the prune belly syndrome) and certain endocrine syndromes. Hormonal therapy, helpful in bilateral prepubertal cases, also may be useful in certain endocrine disorders. Orchiectomy is indicated in unilateral cases with severe neurogenic disturbances that preclude ejaculation, in prepubertal patients with 1 abdominal testis and in postpuberal boys with unilateral cryptorchidism at any site. If risk versus benefit is assessed for each patient these alternatives may be better for him than orchiopexy.
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D003456:Cryptorchidism / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D004542:Ejaculation; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D008607:Intellectual Disability / Q000150:complications; D008297:Male; D012611:Scrotum / Q000601:surgery*; D013737:Testis / Q000601:surgery*
chemical_list: D006063:Chorionic Gonadotropin