Testis fail to descend in scrotum (Undescended Testis)

The testicles are the sex glands in children. The testicles produce testosterone, the sperm and sex hormone needed for reproduction. Undescended testis is a condition which gets unnoticed for years.

When the baby is in the mother’s womb, the baby’s testicles are in the baby’s womb. The testicles usually pass through the inguinal canal into the scrotum before the baby is born. The scrotum is the sac-like part below the penis.

So let’s find out the complete information about Undescended Testis and its ill effects and treatment.

What is Undescended Testis?

If the baby’s testicles do not come down through the inguinal canal, then the condition is called undescended testis. The incidence is 4% to 5% in full term babies and 15 to 20% in preterm babies.

Often the ovary that does not come down in the first few months into the scrotum. Ten percent of infants have a undescended testis on both sides.

What causes undescended testis?

The cause of the undescended testis is not clear. But heredity, maternal health, and smoking during pregnancy can lead to undescended testis.

If the baby is born pretem or if the baby is born low birth weight, the rate of undescended testis is 3 to 4 times higher in such babies than in a normal babies.

What are the symptoms of undescended testis?

The testis which does not come down properly, is near the opening of the inguinal canal. So doctors diagnose undescended testes from physical examination. But if the testis is not detected even by examination in the inguinal canal, it is

  •     May be in the baby’s abdomen.
  •     It may be at the very top of the inguinal canal.
  •     The testis get atrophied and destroyed.

How is undescended testis diagnosed?

The doctor diagnoses the undescended testis with the help of physical examination.Undescended testis diagnosis is confirmed by following test.

Sonography

Sonography of the baby’s abdomen and pelvis reveals where the baby’s testis are located? It is present on both sides, or not? Often this information is enough. Rarely doctor can prescribe an MRI.

What is the treatment for undescended testis?

In 50% of babies with undescended testicles at birth, the testis enter the scrotum between three and four months of age. Therefore, in only 1 to 2 percent of children, the testis does not descend into the scrotum. It requires an operation.

Undescended testicles are operated in two ways, one is by making an incision in the groin called orchidopexy and the other is laparoscopic orchidopexy in which testis pull down in the scrotum with the help of laparoscope and instruments.

Orchidopexy

Pediatric surgeon relocate the baby’s testis from the abdomen and bring them into the scrotum. This operation is called orchidopexy.

The operation involves making an incision in the groin on the side of the baby that has the undescended testis and finding the undeveloped testis, bringing it from the inguinal canal into the scrotum and closing the canal with the help of sutures and that testis is fixed to the scrotum so that the testis does not revolve around itself. The above operation is done by giving anesthesia to the baby.

It is important to operate on undescended testis between the ages of 6 months and 18 months because the main location of the testis is the scrotum, which has one to two degrees Celsius lower temperature than body temperature.

This is because it is needed for sperm formation and if the testis stays in the abdomen, it gets destroyed or the testis are more likely to get cancer in the future. Therefore, it is important to have surgery at a certain age to avoid these side effects.

Laparoscopic orchidopexy

The testis in the abdomen is brought into the scrotum by during this operation with the help of laparoscope. In this operation, small incisions are made in two to three places on the abdomen.

The testis in the abdomen is identified with the help of a camera and brought from the inguinal canal to the scrotum and the passage of the inguinal canal is closed by stitches. And the cuts on the abdomen are also closed by tanks. These slits are very small About 2 mm to 3mm in size.

If your baby is older, the surgeon may advise you to remove the testis of the baby as that testis may have stopped working.

What could be the complications of undescended testis?

1) If the testis does not descend from the inguinal canal into the scrotum, so due to high temperature in the abdomen, testis will not able to form proper number of sperms and quality of sperms will not good.

2) If the testis does not descend from the inguinal canal into the scrotum, then the testis remains in the abdomen, it is more likely to develop cancer in the future. So the doctor may advise to remove it.

3) If the testis does not descend from the inguinal canal into the scrotum, the testis may rotate around itself and twist. This is called testicular torsion. This is an emergency

In this case, the baby needs immediate surgery because the twisting stops the flow of blood to the testis. As a result, the testis eventually stop working and the risk to the baby’s life increases.

4) If the testis is in the inguinal canal, and the area gets injured while the baby is playing, the testis may fail to function.

5) Orchidopexy and Laparoscopic Orchidopexy – Both of these operations need to be performed by a specialist pediatric surgeon. This is because the sperm tube can be injured during the operation, so it should be performed by a pediatric surgeon who specializes in the operation.

Conclusion

If your baby has Undescended Testis, you need to know the following.

  • First of all, your baby needs to be diagnosed with Undescended Testis.
  • Timely treatment is good for the baby’s future. That is why it is better to stay away from some superstitions in the society.
  • With timely treatment, the baby testis can be saved from cancer in the future.

Frequently Asked Questions

Is Undescended Testis a Dangerous Disease?

Undescended testes produce less and low quality sperm, which can lead to future reproductive problems. The incidence of cancer and the movement of the testis around itself can also cause problems. It can also cause mental stress in the future.

Does Undescended gets cure ?

It can descend in 50% of babies in the first three to four months of age.

Can a man live without testis ?

Yes, but it can reduce the chances of future reproduction by up to 50 percent. If undescended testis get operated in time then it increases the chances of reproduction and saves future costs. You know that having a baby costs millions of dollars.

Should the operation of undescended testis be done when the child gets older?

No. This is also a misunderstanding. Due to advances in the medical field, this operation can be performed at a time of 6-12 months, and if the baby’s testis are to be saved and future reproductive problems are to be avoided, it is better to have the operation done in time.

How long does an orchidopexy operation take?

The orchidopexy operation takes about one to one and a half hours due to its delicate location.

After How many days can a baby play after an orchidopexy operation?

The baby can play immediately after the orchidopexy operation. The baby is given medicine by the doctor to reduce the pain and you can’t stop the baby in one place so the baby can start playing right away.

Can orchidopexy operation fail?

The rate of failure of orchidopexy operation is almost non-existent but still it is better to get operated by best pediatric surgeon.

Should orchidopexy operation be performed with laparoscopy?

Depending on the condition of the baby, doctor can tell whether the operation will be done with laparoscopy or not.

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Dr Nikhil Rane is Consultant pediatrician and neonatologist. He likes to provide proper care for children health. He is blogger since last 7 years

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