Undescended testicle - Symptoms, Causes, Risk factors, Diagnosis, Treatment - AINU


UNDESCENDED TESTICLES

Undescended testicles in a newborn are a condition in which one or both testicles have not descended into the scrotal sac before birth. This condition is mostly observed in premature newborns and is also known as Cryptorchidism. Usually, in 90% of cases, only one testicle is not descended but whereas in 10% of cases, both of these testicles are undescended.
      In most of the circumstances the Undescended testicles get into their proper location on its own in first few months of life, If it doesn't correct itself within 6 months then the testicles can be relocated into the scrotal sac through surgery.

Signs & Symptoms
  •          Not observing or absence of feeling a testicle where it is expected to be in the scrotal sac is the major sign of this condition.
  •          In a few instances, there is the presence of swollen lymph nodes in the groin.


Causes
  •         The exact cause of undescended testicles is not known.
  •          A combination of maternal health, genetics & other environmental factors may disrupt the hormones, nerve activity and physical changes that influence the development of testicles.

Risk factors
  •          Low birth-weight
  •         Premature birth
  •          Family history of Undescended testicles or any genital development problems Restricted growth conditions of the fetus such as Down’s syndrome or abdominal wall defect.
  •         Alcohol intake by mother
  •          Cigarette smoking or exposure to Cigarette smoking or pesticides by mother.
  •          Other health-related issues of a mother like – Obesity

Diagnosis
  •          Physical examination.
  •          Ultrasound scan of Scrotum
  •          Tests of hormone levels.


Treatment

If the testicles have not relocated into the scrotum within the first 6 months, then the problem probably won’t correct itself. Treating this Undescended testicle in their early months of infancy for a baby will lower the risk of complications in their later life such as – Infertility, Testicular Cancer.

SURGERY – An undescended testicle is corrected with surgery. The surgeon carefully manipulates the testicle into the scrotum and stitches it into the place which is called Orchiopexy. 

This procedure can be done in either of two ways:

  •   Laparoscopy: In this procedure, a small tube containing a camera is inserted through a small incision into the baby’s abdomen to locate an Intra-abdominal testicle. The doctor may be able to fix the Undescended testicle during the same procedure, but van additional surgery may be required in some cases. In some instances, Laparoscopy may show no testicle present or a small remnant of non-functioning testicular tissue which is then removed surgically.
  •    Open surgery: A larger incision may be necessary for some cases for direct exploration of the abdomen or groin in this procedure.


OTHER TREATMENTS 
  •  If the baby doesn’t have one or both testicles – either missing or did not survive after surgery, then silicone Testicular Prostheses may be considered for the scrotum that can be implanted during late childhood or adolescence. These prostheses give the scrotum a normal appearance.
  •   If the baby does not have at least one healthy testicle, then an Endocrinologist would discuss future hormone treatments that would be necessary to bring about puberty and physical maturity.
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