Cryptorchidism
Description
Cryptorchidism is a condition of retention of the testicle and before the birth of the boy, it has not moved from his abdominal cavity into the scrotum under the penis /scrotum/.
The process of testicular descent is referred to as descensus. Usually one testicle does not descend, but in 10% of cases both male gonads are affected.
An undescended testis is an unusual condition but is quite common in boys born prematurely.
In most cases, the undescended testicle descends into the scrotum in the first few months of the boy’s life and thus takes its proper location.
If your son has an undescended testicle and it takes its position in the pouch of skin under the penis on its own, there is no need for surgery to move the testicle into the scrotum.
What are the symptoms?
The testicle is not visible or palpable in the scrotal sac, this is the main sign of impaired descent.
The testicles are form in the abdomen during the development of the fetus in the mother’s womb. During the last few months of a normal pregnancy, the testicles descend from the abdomen through a canal-like tube towards the groin /inguinal canal/ and take up their final location in the scrotal sac. With an undescended testicle, the process of descent stops or slows down.
What are the causes?
The exact cause of the condition is unknown. A combination of genetic predisposition, maternal health, and other factors such as trauma and nervous excitability can influence the hormones that guide the descent process.
What are the risk factors?
• Low birth weight;
• Premature birth;
• A family history of the condition or of other disorders of genital development;
• Clinical conditions affecting the fetus that may limit its growth, such as Down syndrome or a defect in the abdominal wall.< /em>
• Use of alcohol by the mother during pregnancy;
• Smoking of cigarettes by the mother or her exposure to tobacco smoke;< br/> • Maternal obesity;
• Maternal diabetes – type 1, type 2 or gestational diabetes;
• Exposure to the parents of some pesticides;
Treatment of cryptorchidism
The goal of treatment is to move the descended testicle to its proper place in the scrotum. Early treatment before the age of 1 reduces the risk of complications such as infertility and testicular cancer.
Surgery
An undescended testicle is usually corrected with surgery. The surgeon first locates the testicle in the abdominal cavity and then fixes it in the scrotum. The procedure is called orchipexy and can be done through laparoscopy or open surgery.
When your son’s surgery date is set will depend on a number of factors such as the child’s health and how complex the fixation procedure will be. The surgeon will probably recommend the operation when your son is between 3 and 6 months old and before he is 12 months old. Early surgical treatment is imperative to prevent further complications.
In some cases, the testicle is underdeveloped or its tissue may be altered or dead, then the surgeon will remove this testicular tissue.
If your son has an inguinal hernia related to the undescended testicle, it will be repaired during surgery.
After surgery, the surgeon monitors the testicle to determine whether it continues to develop, functions properly, or stays in place.
Monitoring most often consists of:
• Periodic physical examinations;
• Ultrasound examination of the scrotum;
• Tests of hormone levels;< /p>
Hormonal treatment
Hormonal treatment consists of injecting the human hormone gonadotropin. This hormone can cause the testicle to move into your son’s scrotum. Hormonal treatment is usually not undertaken as it is much less effective than surgery.
