Undescended Testicles : Causes, Risk Factors And Treatment

A testicle that has not descended into the correct place in the pouch of skin hanging below the penis (scrotum) before birth is known as cryptorchidism. One testicle is often afflicted, however, both testicles are undescended around 10% of the time.

Although it is generally unusual, prematurely born males frequently have an undescended testicle.

Within the first several months of life, the undescended testicle almost often goes into the correct position on its own. If your son's undescended testicle does not go down independently, surgery can move it into the scrotum.

Causes

The precise reason for an undescended testicle is unknown. The hormones, physical changes, and nerve activity that affect testicular development may be disturbed by genetics, maternal health, and other environmental variables.

How to check if you have Undescended Testicles?

In most cases, a testicle that has not descended is found when your child is inspected soon after delivery. Ask the doctor how frequently your child will need to be checked if he has an undescended testicle. By the time your child is 4 months old, the testicle should have shifted into the scrotum, but if it has not, the issue is likely to persist.

Infertility problems and testicular cancer may be prevented if an undescended testicle is treated when your child is still a newborn.

Older guys, from neonates to pre-adolescent boys, may subsequently appear to be "missing" a testicle despite having regularly descended testicles at birth. 

A retractile testicle that alternates between the scrotum and the groin might appear. 

During a physical examination, the scrotum may be readily directed by touch. This is a result of a muscular response in the scrotum and is not abnormal.

A testicle that is ascending, or an acquired undescended testicle, that has "returned" to the groin and is difficult to direct into the scrotum with the hand.

Speak to your son's doctor if you observe any changes in his genitalia or are worried about his growth.

Risk Factors

A newborn's likelihood of having an undescended testicle may be affected by a number of factors, such as:

• A small birth weight
• Birth prematurely
• Family history of genital abnormalities, such as testicles that have not descended
• Conditions in the fetus that might limit development, include Down syndrome or a defect in the abdominal wall
• Mother's alcohol consumption during pregnancy
• Mothers smoking cigarettes or being around secondhand smoke
• Exposure of parents to some chemicals

Symptoms

The biggest indication of an undescended testicle is when you cannot feel or see a testicle where you would expect it to be in the scrotum.

During fetal development, the testicles grow in the abdomen. The testicles eventually move from the abdomen into the scrotum during the final few months of a healthy fetus' development through an opening in the groin known as the inguinal canal. That procedure halts or is postponed in the presence of an undescended testicle.

Treatments

The treatment's objective is to relocate the undescended testicle to the scrotum's regular place. The likelihood of undescended testicle issues, such as infertility and testicular cancer, may be reduced by treatment before the age of one year. Although earlier is preferable, surgery should be performed before the child is 18 months old.

Surgery

Surgery is the most typical treatment for an undescended testicle. The surgeon inserts the testicle into the scrotum with caution and sews it there (orchiopexy). Either open surgery or a laparoscope can be used for this technique.

The timing of your son's surgery will depend on a variety of elements, including his health and how challenging the treatment may be. Your doctor will probably advise undergoing the procedure. before he turns 12 months old. The early surgical intervention seems to reduce the likelihood of problems in the future.

The testicle may occasionally be an abnormality or dead tissue with inadequate development. This testicular tissue will be removed by the surgeon.

If your son's undescended testicle is also accompanied by an inguinal hernia, the hernia is fixed during surgery.

Following surgery, the surgeon will keep an eye on the testicle to make sure it keeps growing, functioning normally, and staying in place. Monitoring might consist of:

• Examination of the body
• Scrotum ultrasound examinations
• Hormone level tests
• Hormone therapy
• Human chorionic gonadotropin is injected during hormone therapy (HCG). The testicle might relocate to your son's scrotum as a result of this hormone. 

Other therapies

You may want to think about saline testicular prosthesis for the scrotum, which may be implanted during late childhood or adolescence, if your boy is born without one or both testicles, either because one or both are missing or did not survive following surgery. The scrotum seems normal because of these artificial parts.

Your son's doctor will refer him to an endocrinologist, or a hormone expert, to talk about potential hormone therapies that might be required to induce puberty and physical maturity if your son does not have at least one healthy testicle.

Results

The most popular surgical treatment for treating a single descending testicle, orchiopexy, has a success rate of about 100%. When there are two undescended testicles in a man, it is no longer quite usual to have one undescended testicle. Testicular cancer risk may be decreased but not completely by surgery.

Complications of Undescended Testicles

The temperature of the testicles must be a little lower than that of the rest of the body for appropriate development and operation. This colder climate is provided by the scrotum. The following issues can arise from a testicle not being in the proper place:

Ovarian cancer. The testicular cells that create immature sperm are where testicular cancer typically starts. It is uncertain what triggers these cells to transform into cancer. Men who have had an undescended testicle are more prone to get testicular cancer.

The risk is higher when both testicles are afflicted and the undescended testicles are positioned in the belly instead of the groin. The chance of developing testicular cancer in the future may be reduced, although not entirely, by surgically removing an undescended testicle.

Fertility issues such as lower sperm quality, and low sperm numbers, and men with undescended testicles are more likely to become fertile. If the issue is left untreated for a long time, it may worsen and be caused by the testicle developing abnormally.

The following issues are further caused by the improper placement of the undescended testicle:

Torsion of the testes. The torsion of the spermatic cord, which houses blood vessels, nerves, and the tube that transports semen from the testis to the penis, is known as testicular torsion. This uncomfortable disorder prevents blood flow to the testicles.

This might lead to the testicle being lost if it is not addressed right away. Undescended testicles are 10 times as likely as normal testicles to experience testicular torsion.

Trauma. A testicle in the groin may cause pain or discomfort and a person can be harmed as a result of pressure on the pubic bone.

An inguinal hernia. A part of the intestines may push into the groin if the space between the abdomen and the inguinal canal is excessively loose.

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