Paediatrics: Undescended Testis: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Undescended Testis🎧 A clear, high-yield breakdown of this common congenital genital abnormality in boys – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• Undescended testis (cryptorchidism) refers to one or both testicles failing to descend into the scrotum by birth.• Classified as palpable or non-palpable, and may be retractile, ascending, maldescended, ectopic, or absent.📌 Causes & Risk Factors• Multifactorial: hormonal, genetic, anatomical• Risk factors:• Premature birth• Low birth weight• Family history of undescended testes• Maternal smoking during pregnancy• Genetic syndromes: Prader-Willi, Kallmann💡 Mnemonic: “PREM-Low-Fam-Smoke-Syndrome”📌 Pathophysiology• Testes normally descend from the abdomen to the scrotum via the inguinal canal• Undescended testis occurs when descent is arrested, diverted, or reversed• Can result from hormonal disruption, gubernaculum abnormalities, or anatomical obstruction📌 Symptoms• Empty scrotum (uni- or bilateral)• Palpable testis in groin, thigh, or ectopic site• Retractile testis may descend temporarily then retract• Occasionally: groin swelling or discomfort📌 Differential Diagnosis• Retractile testis (manipulable down)• Ascending testis (was down but moved up)• Testicular agenesis (never formed)• Testicular atrophy (shrunken and non-palpable)📌 Diagnosis• Physical examination (multiple positions, minimise cremasteric reflex)• Ultrasound/MRI for non-palpable cases• Laparoscopy is gold standard if testis not found• Urgent endocrine/genetic workup if bilateral non-palpable💡 Tip: Examine in warm room; check scrotal symmetry and ectopic sites📌 Management• Watchful waiting until 6 months (some descend spontaneously)• Referral at 3 months, specialist review by 6 months• Orchidopexy surgery at 6–12 months (ideally before 18 months)• Laparoscopy for non-palpable testes• Hormonal therapy (HCG/GnRH) now rarely used due to limited efficacy and side effects✅ NICE: Early surgical referral and correction reduces infertility and cancer risks📌 Complications• Infertility or subfertility (especially bilateral cases)• Testicular torsion• Increased risk of testicular cancer (3–5x higher)• Psychological distress or cosmetic concerns• Testicular trauma or prosthesis placement if removed📌 Prognosis• Excellent with timely surgery• Regular follow-up important due to residual cancer risk and fertility monitoring• Orchidopexy improves cosmetic outcome and allows self-examination📎 More MSRA Resources for Undescended Testis📝 Revision Notes: https://www.passthemsra.com/topic/undescended-testis-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/undescended-testis-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/undescended-testis-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/undescended-testis-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/quizzes/undescended-testis/Hashtags#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQ&ANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #Paediatrics #UndescendedTestis #Cryptorchidism