Undescended testicle or cryptorchidism is when one of both the testicles don’t move down into their proper anatomical position in the scrotum from the abdomen before birth. Commonly, just one testicle is affected, but it can be bilateral in about 10 percent of the cases. The incidence of cryptorchidism is higher in boys born prematurely, which is why their pediatrician or Best Child specialist in Lahore would always check to see if the testicles are descended.
What are the causes of cryptorchidism?
The exact cause of cryptorchidism is not exactly understood. The health of the mother, the genetic makeup of the baby as well as external dynamics are thought to be some of the deciding factors.
Some elements that make cryptorchidism more likely include: pre-mature birth of the baby, low birth weight of the baby, growth restriction of the baby due to Down syndrome, family history of cryptorchidism, abdominal wall defect, family history of hormonal disorders, exposure to chemicals like pesticides during gestational period. Additionally, if the mother is diabetic, the chances of cryptorchidism increase markedly. The probability is also higher in mothers who are active or passive smokers and drink alcohol.
How to tell your baby has cryptorchidism?
Cryptorchidism is diagnosed by the pediatrician during the initial examination of the baby after birth. The main sign is the absence of testicle on palpation of the scrotum. Testicles are formed during gestation in the abdomen of the baby, and then descend down to the scrotum; any interruption of this process due to hormonal changes, growth retardation or abdominal wall defect etc. can result in cryptorchidism.
The process can be delayed, and the testicle will descend by itself up till the fourth month after birth, or it has halted completely, in which case intervention would be needed.
When to see a doctor?
Most cases of undescended testicles solve by themselves as the testicles descend soon after birth. However, if they are not in their normal anatomical position four months after birth, you would need to see a healthcare provider.
Doctors need to rule out other reasons for undescended testicles, such as:
Ectopic testicles: this is the condition whereby the testicle don’t fall into the scrotum and are located somewhere along the inguinal canal or the abdomen.
Retractile testicles: this is when the doctor can gently pull the testicles into the scrotum by hand.
What are the risks associated with undescended testicles?
Later on, in adulthood, undescended testicle(s) is linked to higher risk of testicular cancer despite surgical treatment. Testicular torsion, i.e. when the testicle twists around the cord carrying sperm to the penis. This is a very painful condition as the blood supply is compromised and may result in permanent damage. The probability of inguinal hernia also increases in people with cryptorchidism. Additionally, there are chances of fertility problems as there is damage to the organ.
What are the treatment options for undescended testes?
Most cases of undescended testicles resolve on their own. However, if they don’t, treatment with surgery is the likely course to be recommended by the pediatrician or Best Child specialist in Islamabad.
The procedure is known as orchidopexy, whereby the testicles are manipulated into the scrotum and stitched into place. Orchidopexy can be done through laparoscopy or an open approach. It’s most effective when the baby is 6 to 12 months old as it can protect the baby from infertility later on in life. The baby is thereafter monitored with ultrasound of the scrotum, hormone levels, and physical exams. The other unconventional treatment option is hormonal therapy. However, it is less effective than surgery and may be associated with side effects.
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