Cryptorchidism associated with myelomeningocele

Objective: The authors studied 75 male infants with meningomyelocele (MMC) to analyse the association with cryptorchidism. Methods: All infants were diagnosed at birth and surgically corrected after 24–48 h. Testes were classified undescended in accordance with Kaplan. The associated malformations, the exact levels of the lesion (surgical report) and the presence of hydrocephalus and the cremasteric reflex have each been assessed. Results: In these patients a higher incidence of cryptorchidism (14.8%) was found than in the normal population. Lesion level (L2–L3) and absence of cremasteric reflex was higher in children with associated cryptorchidism. Infants with MMC and undescended testes showed no increased incidence of hydrocephalus and sexual hormone levels remained within the normal range. These results suggest that the cremaster muscle could be a major factor involved in testis descent through the inguinal canal. Conclusions: The authors propose that spinal cord lesion, as well as neurologic dysfunction, is of major importance in the pathophysiology of cryptorchidism in spina bifida.