Can chiropractors cure Cryptorchidism?

Can chiropractors treat undescended testicles without surgery? That is the claim of two case studies, published in 1999 and 2003.

In the one from 1999, published in the Journal of Clinical Chiropractic Pediatrics,  a boy who they conclude has retractile testicles makes an improvement with intense chiropractic treatment over 4 months. The chiropractor posits why the treatment ‘worked’:

Four possible explanations may explain why chiropractic adjustments provided results with this case:

1. A pelvic joint dysfunction existed causing the inguinal canal, superficial inguinal ring or related soft tissue structures to be torqued or narrowed to the extent that it disallowed complete testicular descent. Upon removal and stabilization of the joint dysfunction, soft

tissue compromise on the inguinal canal and/or superficial inguinal ring was removed allowing for widening of these structures and the continued descent of the testes into the scrotal sac.

2. In this case of cryptorchidism consider the involvement of the following 2 muscles and their nerve supply. The cremaster muscle is a covering that the internal oblique and transversus abdominus give to the spermatic cord and testis. The action of the cremaster muscle is to retract the testis. It’s nerve supply is the genitofemoral nerve which originates from the first and second lumbar nerve roots.

The psoas muscle takes origin from the lateral sides of the vertebrae and intervertebral disc of the twelfth thoracic through the fifth lumbar. Therefore, in this author’s opinion, a spasm of the psoas muscle may cause vertebral joint dysfunction at any level from T12-L5 with associated aberrant nerve function. This in turn may cause retractile testes due to an exaggerated cremasteric reflex.

3.Another possibility exists with the same structures noted previously in that the ventral rami of L1-L4 nerve roots pass through the psoas muscle as they emerge from the intervertebral foramina.

Therefore, in this author’s opinion, impingement and resulting nerve pressure of the L1 and L2 nerve roots or the genitofemoral nerve as it passes through a spasmed psoas muscle may cause retractile testes due to an exaggerated cremasteric reflex.

4. One can also consider the possibility of spontaneous remission in close proximity to the commencement of chiropractic adjustments. however, due to the immediate response to the adjustments coupled with the return of the sacroiliac joint dysfunction and the condition, followed by several episodes where the joint dysfunction and condition appear to be present and then in remission at the same time, it is this author’s opinion that spontaneous remission does not seem exceedingly likely.
From 2003 we have a far vaguer, brief and altogether less satisfying case study (although perhaps more believable outcome) from Dr Bill Maykel, who says that a couple of manipulations on a 9 month old baby released the testicle, and that it was still descended 4 years later.
Those are the only two case studies or studies I can find about using chiroprody to treat cryptorchid testis (undescended testicles).

[Todo: Contact http://icpa4kids.org/ and ask if they know of research?]

It sounds plausible but a few thoughts:

  1. Why has no one repeated the results and published? To be able to cure something the medical profession have to resort to surgery for would be big news
  2. Many cryptorchid testis have an associated hernia. No amount of “opening up the passage to allow the testicle to descend” is going to fix the hernia, which will cause problems later in life.
  3. The 1999 case report admits that the child probably had a retractile testicle. This is not a child with cryptorchidism as they claim, and we now that as the child approaches puberty there is every chance it will descend automatically.
  4. The 2003 case study has a more satisfying outcome, but scant details or evidence.

Conclusion

It would be nice to think that the reason a testicle doesn’t descend properly is due to pelvic misalignment, and a few simple manipulations can cure an undescended testicle. I would like to see further studies, as for certain types of cryptorchidism this could be the cause. In most cases however, it is not a case of the passage through which the testicle descends is too small, or that the cremaster muscle is too strong.

http://www.lalecheleague.org/nb/nbnovdec03p213.html

Try and find PDF https://www.ncbi.nlm.nih.gov/pubmed/8094761