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Orchiopexy

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Orchiopexy

Undescended Testicle – Overview

An undescended testicle (cryptorchidism) refers to a testicle that has failed to move into its proper position before birth. Its ideal position is within the bag of skin hanging right below the penis, known as the scrotum. Generally, it is only one of the two testicles that are affected, however, 10 percent of the time, you may find both testicles undescended. An undescended testicle is not very common, but, it is commonly found among baby boys born prematurely.

What Is An Undescended Testicle?

An undescended testicle is also known as cryptorchidism. During the early phase of pregnancy, the testicles are formed within the womb, and by 32-36 weeks, the testicles begin to move down into the scrotum. In many of the boys born prematurely or some born as full-term infants, one or both of the testicles fail to descend at the right time which is ideally at birth. 

Several crucial changes occur within the womb in the last few months of pregnancy. It is also when the testicles in boys descend from the lower belly into the scrotum which is a bag of skin situated below the penis.

Also Read: Varicose Veins

The testicles are supposed to descend from the abdomen through the inguinal canal (a tubelike passageway in the groin) to the scrotum. In some cases, the process stops or is delayed and one or both of the testicles fail to descend to their proper position and are referred to as an undescended testicle.

The testicles should ideally descend into the scrotum by the time the baby turns six months but if this does not happen the child may have to undergo surgery. Your pediatrician will be able to guide you on the management of an undescended testicle.

What Causes An Undescended Testicle? What Are The Associated Risk Factors?

While the exact cause is not known, a combination of maternal health, genetics, and other environmental factors are considered the possible causes, which can disrupt the development of the male reproductive system.

Certain factors that contribute toward enhancing a newborn’s risk of developing this condition include:

  • Premature birth or low weight at the time of birth
  • Family history of undescended testicles or other genital development issues
  • Certain medical conditions such as Down syndrome 
  • Cigarette smoking by the mother or even exposure to secondhand smoke
  • Alcohol usage by the mother during pregnancy
  • Exposure of the parents to certain pesticides 

What Are The Symptoms Of An Undescended Testicle?

Some possible signs and symptoms of an undescended testicle include:

  • Missing or undetectable testicles: One or both testicles may not be visible or palpable in the scrotum, especially in newborns or infants.
  • Abnormal positioning of the testicle: In some cases, the testicle may be located in the inguinal canal or the abdomen.
  • Smaller or underdeveloped testicle: The undescended testicle may be smaller or underdeveloped compared to the normally descended testicle.
  • Pain or discomfort: Older boys or men with undescended testicles may experience discomfort, pain, or heaviness in the groin area.

It's important to consult with a healthcare professional in Hoshiarpur if you or your child has any signs or symptoms of an undescended testicle.

When To See A Doctor?

Every newborn undergoes an examination by a neonatologist after birth. If the doctor notices an undescended testicle during this examination the doctor might ask you to wait for a period of 5 to 6 months as it may naturally descend within this time period. You will be asked to take consultations in between to keep a check on the condition. In infants, undescended testicles usually descend into the scrotum by the age of 6 months. If the testicle fails to descend within this time period, your doctor might consider surgery.

Diagnosing Undescended Testicles

The following tests are performed in order to diagnose an undescended testicle:

Physical Examination: During the exam, the doctor will feel the scrotum to determine if the testicles are present and in the correct position.

Ultrasound: This imaging test uses high-frequency sound waves to create images of the testicles and surrounding tissues. Ultrasound can help determine the position and size of the testicles.

Hormone tests: Blood tests can measure hormone levels that are involved in the development of the testicles. Abnormal hormone levels can indicate a problem with the testicles.

Laparoscopy: This is a minimally invasive surgical procedure in which a thin, flexible tube with a camera is inserted through a small incision in the abdomen to visualize the position of the testicles.

It is important to diagnose undescended testicles as early as possible to prevent potential complications, such as infertility and testicular cancer.

How Is An Undescended Testicle Treated?

In Infants: In infants, the condition may resolve on its own within the first year of life. However, if the testicle has not descended by the age of 6 months, treatment may be necessary. The most common treatment for undescended testicles in infants is surgery, which involves making a small incision in the groin and bringing the testicle down into the scrotum.

In older children and adults: Here, surgery may also be recommended. In some cases, hormonal therapy may be used to encourage the testicle to descend. However, if the testicle has not descended by puberty, surgery is usually necessary.

It's important to note that undescended testicles can increase the risk of infertility and testicular cancer, so it's important to seek treatment if you or your child has this condition.

What Are The Possible Complications Of An Undescended Testicle?

Following complications can arise as a result of undescended testicles:

Fertility problems: Poor sperm quality, low sperm count, and decreased fertility are likely to occur.

Testicular Cancer: Men with an undescended testicle are at an increased risk of getting testicular cancer. The risk is even greater when the undescended testicle is in the abdomen than when it’s in the groin, and when both testicles are affected.

Testicular Torsion: The spermatic cord, carrying semen from the testicle to the penis, may become twisted. This causes pain and cuts the blood supply to the testicle. This may make the person lose the testicle without prompt treatment. Patients with undescended testicles have 10 times more chances of having testicular torsion.

Trauma: A testicle in the groin can be damaged because of pressure from the pubic bone.

Inguinal hernia: A part of the intestines may push into the groin when the opening between the groin and abdomen is too loose.

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