Clinical Skills 1 (Cryptorchidism)

Drawing of the clinical examination of a boy with suspected left-sided cryptorchidism. In the cross-legged position (so-called tailor's seat) the patient sits with abducted and angled legs. During palpation of the left scrotum and of the soft tissues above it by the right hand the left hand strips off the inguinal channel smoothly in a distal direction. a. In high-scrotal retention the testis is palpated at the entrance of the scrotum. b. In prefascial ectopia ('sliding testis') the testis can be palpated and seemingly moved into the scrotum, but on release of the traction the testis slides again to its original position. c. In low canalicular retention the testis is palpable, but moving it in the direction of the scrotum is impossible. d. In abdominal or high canalicular retention the testis is not palpable at all in spite of a correct technique of clinical examination. In case of obesity and/or testicular hypoplasia this statement also concerns the types mentioned in a to c.