Pathogenesis (development of disease)
The cause of cryptorchidism is multifactorial, and the involvement of various factors (descensus (“descent”) of the epididymis, gubernaculum testis, ligamentum diaphragmaticum, nervus genitofemoralis, processus vaginalis) is discussed. In most cases, it is seen as a result of intrauterine (“inside the uterus“) insufficiency (weakness) of the hypothalamic-pituitary-gonadal axis (diencephalic-pituitary-gonadal axis). It can be considered as a passive prenatal (before birth) and prepubertal (before puberty) hypogonadotropic hypogonadism (gonadal hypofunction caused by lack of stimulation from the glandotropic hormones FSH and LH) and discusses an “intrauterine insufficiency of the hypothalamic-pituitary-gonadal axis”. For this reason, maldescensus testis is included among the endocrinopathies (disease of the endocrine glands).
Etiology (Causes)
Biographic causes
- Genetic burden, due to gene mutations.
- Birth weight < 2,500 g as well as premature birth.
- Hormonal factors – see below pathogenesis.
Behavioral causes
- Consumption of stimulants
- Tobacco (smoking)
Causes related to disease
- Diabetes mellitus (diabetes)
Operations
- Condition after previous surgery in the inguinal region (e.g., inguinal hernias (inguinal hernia) or hydroceles (hydrocele testis, water hernia; accumulation of fluid in the scrotum)). → secondary ascension (rising) of a primary scrotal (in the testis) palpable (pendulum) testis due to scarring.
Environmental pollution – intoxications (poisonings).
- Diethylstilbestrol (DES)
- Mono esters of phthalates Note: Phthalates belong to the endocrine disruptors (synonym: xenohormones), which even in the smallest amounts can damage health by altering the hormonal system.
- Persistent organochlorine compounds
- Polybrominated diphenyl ethers (PBDEs)
