Undescended Testis

Undescended testis

One or both testicles fail to descend into the scrotum before to birth, leading to an undescended testis. the scrotum being devoid of either one or both testicles. Kryptos, which means hidden, and orchis, which means testicles, are other names for cryptorchidism.

It is a testicle that hasn't moved into the Scrotum, the bag of skin before birth, where it should be.

Classification according to location

• AAbdominal: Proximal to the internal inguinal ring, the testes descend.
• Canalicular: Between the internal and external inguinal rings, the testicles descend.
• Ectopic: Testes drop via alternate routes ( between the abdominal cavity and the scrotum ).

Causes

• premature baby
• Low birth weight baby
• Family history of genital development issues, such as undescended testicles.
• Conditions in the fetus that can limit growth, like Down syndrome or a defect in the abdominal wall.
• Mother smoking cigarettes or being around secondhand smoke.
• The mother's obesity.
• Diabetic mother.

Pathophysiology

The testes are often located in the belly of the fetus. During the final seven to nine months of pregnancy, they move into the scrotum through the groin as they mature. Undescended testes will develop if, for any reason, the testes are unable to travel normally through the inguinal canal to the scrotum or if, while descending, they are stopped somewhere along their course.

Clinical presentation

• Parents, a nurse, or a doctor may be present to see nonpalpable testicles.
• If only one testis is undescended, the affected testis will appear smaller than the unaffected testis.
• Scrotum missing or lopsided.
• Empty scrotum or one with unusual size and shape.

Diagnosis

• Observation and infant presentation.
• Testes should never be milked or forced back into the scrotum during a testicular examination.
• The testis can be felt along the inguinal canal, but not in the abdominal cavity, if the child is squatting or if finger pressure is applied to the external ring before palpating the abdomen or genitalia.
• Blood test: to determine the level of the gonadotropin hormone in an individual's blood.
• Laparoscopy, MRI, CT scan, and ultrasonography.

Management

• Surgery : Before the child's second year of age, orchidopexy is performed. 6 to 24 months old is the ideal age for surgery.
• Hormone therapy : Injections of human chorionic gonadotropin and luteinizing hormone-releasing hormone may also be used as a trial basis for treatment.
• Others
  • Due to the higher level of body heat, protect the undescended testis.
  • Avoid torsion and trauma.
  • avoid the psychological and cosmetic disadvantage of having an empty scrotum. In the standard procedure, the testes are lowered into the scrotum and held there without tension.

Nursing consideration

• Nursing care should be given to a child's condition assessment, surgical planning, and post-operative nursing care to reduce infection.
• Washing the surgical site, the feces, and the urine with care.
• Parents and children are reassured.
• Encourage the parents to emphasize to their developing child the value of testicular self-examination and to administer prompt treatment when necessary.

Complications

• Testicular cancer
• Infertility
• Inguinal hernia