Description

A testicle that has not moved down into their proper place in the scrotum before birth is called an undescended testicle. It is also known as cryptorchidism (krip-TOR-kih-diz-um). More often, it is only one of the testicles that do not descend into the scrotum, which is the pouch of skin that hangs below the penis. But sometimes both testicles are affected.

An undescended testicle is more common in premature infants than in term infants. An undescended testicle is often moves down on its own within a couple of months after the baby is born. If your baby has an undescended testicle that does not correct itself, the surgery can be performed to move the testicle into the scrotum.

Symptoms

Do not see or feel a testicle in the scrotum is the main symptom of an undescended testicle.

The testes form in an unborn baby the lower part of the abdomen. During the last months of pregnancy, the testicles will usually move down from the stomach area. Move through a tubular passage in the groin, called the inguinal canal, and descend into the scrotum. With an undescended testicle, the process stops or is delayed.

When to see a doctor

An undescended testicle is often discovered during a test performed shortly after birth. If your baby has an undescended testicle, ask how often the tests should be done. If the testicle has not moved into the scrotum by 3 to 4 months of age, the condition is likely to correct itself.

The treatment of cryptorchidism when the child is still a baby can reduce the risk of health problems later in life. These include cancer of the testicles, and not being able to get a partner pregnant, also called infertility.

Older children, from babies to teenagers — who have descended testicles at birth might seem to lack a testicle later. This could be a symptom of:

  • A testicle shrink, which moves back and forth between the scrotum and the groin. The testicle may be easily guided by hand into the scrotum during a physical exam. A testicle shrink is due to a reflex muscle in the scrotum.
  • Ascending testicle, which has returned to the area of the groin. The testicle may not be easily guided by hand into the scrotum. Another name for this is acquired undescended testicle.

Talk with your child's doctor or another member of your care team if you notice any changes in your child's genitals or if you have other concerns.

Causes

The exact cause of an undescended testicle is not known. The Genes, the health of mother and baby and other factors could have a combined effect. Together they can alter the hormones, physical changes and the activity of the nerve that play a role in how the testicles develop.

Risk factors

Things that may increase the risk of a testicle that has not descended in a newborn include:

  • Premature birth or low birth weight.
  • Family history of undescended testes.
  • Health conditions in the baby, such as cerebral palsy or a problem with the wall of the abdomen.
  • The mother of diabetes before or during pregnancy.
  • The use of Alcohol during pregnancy.
  • Cigarette smoking or exposure to second-hand smoke during pregnancy.
  • Exposure to pesticides during pregnancy.

Complications

The testes need to be slightly cooler than normal body temperature to develop and work well. The scrotum offers this cool place. The complications of a testicle that is not where it is supposed to include:

  • Testicular cancer.Men who have had an undescended testicle have an increased risk of testicular cancer. This disease often begins in the testis of cells that produce immature sperm. It is not clear why these cells become cancer. The risk is higher in men who have had an undescended testicle is located in the area of the stomach in men that I have had undescended testes in the groin. The risk is also greater when both testicles are affected. The surgery to correct an undescended testicle may decrease the risk of testicular cancer. But the risk of cancer does not go away completely.
  • Fertility problems. These issues make it more difficult to get a partner pregnant. It is more likely to occur in men who have had an undescended testicle. Fertility problems could be worse, if an undescended testicle goes without treatment for a long time.

Testicular cancer. Men who have had an undescended testicle have an increased risk of testicular cancer. This disease often begins in the testis of cells that produce immature sperm. It is not clear why these cells become cancer.

The risk is higher in men who have had an undescended testicle is located in the area of the stomach in men that I have had undescended testes in the groin. The risk is also greater when both testicles are affected. The surgery to correct an undescended testicle may decrease the risk of testicular cancer. But the risk of cancer does not go away completely.

Other health conditions associated with an undescended testicle, which include:

  • Testicular torsion. This is the torsion of the cord that brings blood to the scrotum. It is a painful problem that cuts off the blood supply to the testicle. Without quick treatment, the testicle may become so damaged that needs to be surgically removed.
  • The Trauma. If the testicle is located in the groin area, may be damaged by the pressure against the pubic bone.
  • Inguinal Hernia. A part of the intestines can push you in the groin through a weakness in the muscles of the stomach area. The bulk of this cause can be painful.

Diagnosis

With an undescended testicle, surgery may be needed to find the problem and treat it. There are two main types of surgery:

  • The laparoscopy.A small tube with a camera that is placed through a small incision in the abdomen. Laparoscopy is performed to locate a testicle in the stomach area.
  • The open surgery. This uses a larger incision to look inside of the area of the stomach or groin, to find the undescended testicle.

The laparoscopy. A small tube with a camera that is placed through a small incision in the abdomen. Laparoscopy is performed to locate a testicle in the stomach area.

The surgeon may be able to fix the testicle that has not descended during the same procedure. But another surgery may be necessary. Sometimes, laparoscopy can not find an undescended testicle. Or can you find damaged or dead tissue of the testicle that does not work, and the surgeon removes.

If a baby's testicles are not in the scrotum after birth, more tests may be needed. These tests can determine if the testes are absent, that is to say, there is nothing more that of undescended. Some health problems that lead to the absence of the testes can cause serious problems soon after birth if not detected and treated.

Imaging tests, such as ultrasound and magnetic resonance imaging , in general it is not necessary to know if a baby has an undescended testicle.

Treatment

The goal of treatment is to move the testicle that has not descended to its proper place in the scrotum. Treatment before the age of 1 may decrease the risk of health problems associated with an undescended testicle, such as infertility and testicular cancer. Early treatment is best. The experts recommend that the surgery takes place before the child is 18 months of age.

Surgery

More often, an undescended testicle is fixed with surgery. The surgeon moves the testicle into the scrotum and stitches in place. This is the so-called orchiopexy (Or-kee-o-pek-see). It can be done through a small incision in the groin, scrotum, or in both.

The time for when your baby is of the surgery will depend on many factors. These include the health of the baby and the strength of the procedure could be done. Your surgeon will likely suggest you do the surgery when your baby is somewhere between 6 and 18 months of age. Early treatment with surgery appears to reduce the risk of later health problems.

In some cases, the testicle may be damaged or made of dead tissue. The surgeon should remove this tissue.

If your baby also has an inguinal hernia, the hernia is repaired during the surgery.

After the surgery, the surgeon controls the testicle to see that develops, works to the right and stays in place. The monitoring may include:

  • Physical examinations.
  • Ultrasound exams of the scrotum.
  • The evidence of the levels of the hormone.

Hormone treatment

With the hormone treatment, your child is given shots of a hormone called human chorionic gonadotropin. This could cause the testicle to move the scrotum. But the hormone treatment often is not recommended, because it is much less effective than surgery.

Other treatments

If your child does not have one or both of the testicles — because one or both are absent or have been removed during the surgery — and other treatments can help.

You can think of to get your child testicular prosthesis. These artificial implants can give you the scrotum a regular appearance. Are placed in the scrotum with surgery. That can be implemented in less than six months after a scrotum procedure or after puberty.

If your child does not have at least one testicle healthy, you may be referred to a hormone expert called to an endocrinologist. Together, we can talk about future treatments of the hormone that is needed to bring about puberty and the physical maturation.

Results

Orchiopexy is the most common surgery to correct a single undescended testicle. It has a success rate of almost 100%. Most of the times, the risk of fertility problems go away after the surgery for a single undescended testicle. The surgery with two undescended testes gives less of an improvement. The surgery may also reduce the risk of testicular cancer, but does not eliminate the risk.

Lifestyle and home remedies

Even after surgery, it is important to verify that your baby's testicles to make sure they develop properly. You can check the position of the testes during diaper changes and baths.

When your son is about to reach puberty, the two of you can talk about what physical changes to expect. During the chat, you can explain how your child can check the testicles without your help. Your child should do a self-exam each month. This is a key skill to help find lumps and other possible symptoms of early tumors. Make an appointment with your child's doctor if your child notices any unusual changes in the testes.

Coping and support

Your child might be sensitive about how the scrotum is seen without one or both testicles. It is normal to feel anxious to see me different from friends or classmates, especially in a locker room where students undress. The following tips can help:

  • Teach your child the right words to use when talking about the scrotum and testicles.
  • Explain that there are often two testicles in the scrotum. If one or both are missing, explain what that means and why your child is still a healthy kid.
  • Tell your child that you have an undescended testicle is not a disease.
  • Discuss if a testicular prosthesis is a good option for your child.
  • Help your child practice how to explain the undescended testicle to any bullies or children who ask questions.
  • Buy your child loose boxer shorts and bathing suits. These can make the testicle not descended more difficult to notice when changing clothes and play sports.
  • Be aware of the signs of concern or embarrassment. For example, your child may stop playing a sport that you used to enjoy.

Preparing for your appointment

An undescended testicle is often found in the birth. Your family doctor or pediatrician to check the condition during routine visits and checkups for your child.

To prepare for your appointment, write down a list of questions to discuss with your child's care team. The questions may include:

  • How often should I schedule appointments?
  • How can I check how securely the scrotum in the house to notice any change in the undescended testicle?
  • When we suggest you to see a specialist?
  • What kinds of tests will my child need?
  • What treatment options do you suggest?
  • Are there brochures or other printed material that I can take my house? What websites do you suggest?

Feel free to ask questions during your appointment.

What to expect from your doctor

Your child's doctor will check your groin. If the testicle is not in the scrotum, the provider will try to find it by pressing gently against the skin. A lubricant or warm, soapy water can be used for the test.

If the testicle can be felt somewhere in the inguinal canal, your child's doctor, you can try to move gently in the scrotum. Could be an undescended testicle if:

  • Moves up to the half in the scrotum.
  • The movement appears to be the cause of the pain.
  • The testis is returned to its original location immediately.

It's most likely a testicle shrink if you can move something easily in the scrotum and is left there for a time.

If your baby's testicle does not has to be moved down or can not be found by around 6 months of age, you may need to see a specialist for more tests. You can see a doctor who is trained in the genital and urinary tract problems, called a pediatric urologist. Or you could go to a doctor who is trained to do surgeries on children, called to a pediatric surgeon.

Symptoms and treatment of cryptorchidism