Comments on the article “Clinical and anatomical features of the primary acquired cryptorchidism”

The article by Yuri N. Bolotov, Sergey V. Minaev and Diana M. Kargaeva "Clinical and anatomical features of the primary acquired cryptorchidism" analyzes outcome after treating two groups of patients with the primary acquired cryptorchidism (studied group) and with congenital undescended testicle of inguinal and abdominal forms ( control group).

It should be noted that term "primary acquired cryptorchidism" does not reflect , unfortunately, causes of this condition which can lead to the confusion related to disease pathogenesis and choice of proper treatment tactics. The most applicable and generally accepted term in Russian literature is "testicular retraction."

In case of inguinal cryptorchidism, the testicle remains in the lumen of the canal and does not move beyond the superficial inguinal ring; besides, there are other variants of testicular disorder during its descending into the scrotum because of the violated fixation of the testicular conductor. In such cases, the testicle is located outside the inguinal canal and the superficial inguinal ring, but not in the scrotum. We are talking about testicular ectopia and its forms (inguinal, perineal, femoral, etc.). A distinctive feature of testicular ectopia is the obliteration of the vaginal process, and the place of conductor fixation is located outside the same half of the scrotum.

While analyzing retraction causes, it is necessary to remember disorders in the testicle ligamentous apparatus, deviations in the formation of which can lead to twisting of the spermatic cord. It is extremely rare that children with inguinal retraction have an unobliterated vaginal process of the peritoneum.

In the vast majority of cases, monitoring of such condition, understanding of its mechanisms and terms of its development prevent unjustified surgical interventions and promote the choice of a proper management strategy.