Definition Undescended testicle, called cryptorchidism, refers to a testicle that fails to move into the scrotum. This is a condition that is present at birth.
What is going on in the body? The testes move from inside the abdomen into the scrotum during a baby's development. The testicles are found in the scrotum in 97% of boys born at full term. The testicles may not move into the scrotum in up to one-third of premature infants. Some testicles continue moving and reach the scrotum during the first year of life. If the testicles have not moved into the scrotum by one year of age, it is unlikely that they will ever do so.
What are the signs and symptoms of the condition? The testicles are noted to be absent in the scrotum by the parent or doctor. In most cases, only one testicle is affected, but both can be involved. There are usually no other signs or symptoms. This condition sometimes occurs along with other physical defects.
What are the causes and risks of the condition? The exact causes of this condition are still a subject of debate. There appear to be both hormonal and mechanical factors at work. This condition is much more likely to occur in premature infants. The earlier a child is born, the more likely the child is to have this condition. Certain inherited conditions can also make this condition more likely to occur.
What can be done to prevent the condition? There are no known ways to prevent this condition.
How is the condition diagnosed? Careful and gentle physical examination of the child can usually diagnose this condition. A urologist, or doctor who specialises in treatment of conditions of the kidney, bladder and genitals, is usually consulted. If both testes are unable to be felt with the hand, hormone levels are checked to make sure the child has testicles. Other conditions that can cause an inability to feel the testicle must be ruled out. For example, some testicles occasionally move up into the abdomen but are usually in the normal location. X-ray tests are sometimes used to locate the testes. Currently, most urologists use laparoscopy to locate the testicles and guide further therapy. During this procedure, a narrow telescope is placed into the abdomen to search for the testicles.
What are the long-term effects of the condition? This condition increases the risk for cancer of the testicle. It has been estimated that roughly 10% of men who developed this cancer had undescended testicles.
Torsion of the testicle is more common than in normal testicles. This condition is a twisting of the testicle around its blood supply that may cause the blood supply to be cut off. Testicles that have been replaced are much less likely to develop this problem.
Hernias in the groin area develop in most people with this condition.
Fertility, or the ability to father children, is reduced in men with an undescended testicle on one side. It is very poor in men that are affected on both sides.
What are the risks to others? This condition cannot be passed from one person to another.
What are the treatments for the condition? The primary treatment for this condition is surgery. Often, a child is watched until the age of one to see if the testicle will move into the scrotum by itself. If not, affected testicles can be brought down into the scrotum using surgery. Surgery improves cosmetic appearance and makes examination of the testicles to check for cancer easier. Surgery may also improve the chance of future fertility in some cases.
What are the side effects of the treatments? There is little discomfort after most procedures to repair this condition. The recovery time is usually short. Laparoscopy generally results in a faster recovery, but in young children, fast healing is the rule after any surgery. The primary risk of the procedure is failure. This may mean the testicle cannot be found or is damaged during the surgery. As with all surgeries, there is a chance of bleeding, infection and reactions to the medication used for pain control.
What happens after treatment for the condition? After a short recovery time, the child can return to normal activities.
How is the condition monitored? After surgery, periodic physical examination of the testicles is required. Surgery to correct this condition does not reduce the risk of cancer of the testicle.
Author: Stuart Wolf, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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