Undescended Testes

Subject: Midwifery III (Theory)

Overview

An undescended testicle (cryptorchidism) is one that has not moved down into the scrotum and has remained inside the body. It is possible that one or both testicles will be affected. A boy's testicles usually descend by the time he is 9 months old. Undescended testicles are fairly common in premature infants. In fullterm infants, the problem is less common. Some babies have retractile testes, which causes the health care provider to be unable to locate the testicles. The testicle is normal in this case, but it is pulled back out of the scrotum by a muscle reflex. Other than the absence of the testicle in the scrotum, there are usually no symptoms. In most cases, the testicle will fall out without treatment during the procedure.

Undescended testes:

An undescended testicle (cryptorchidism) is one that has not moved down into the scrotum and has remained inside the body. It is possible that one or both testicles will be affected.

Undescended testicles are frequently classified based on their location and whether or not they can be felt (palpable or nonpalpable).

Abdominal:
During a physical exam, the testicle remains inside the abdomen and cannot be felt (is nonpalpable). It is usually located near the inguinal canal's inner opening.
Inguinal:
The testicle terminates in the inguinal canal and is usually not palpable during a physical examination.
Prescrotal or prepubic:
The testicle descends further down the inguinal canal but does not reach the scrotum. During a physical examination, it is usually felt (palpable).

Causes:

A boy's testicles usually descend by the time he is 9 months old. Undescended testicles are fairly common in premature infants. In full-term infants, the problem is less common.

Some babies have retractile testes, which causes the health care provider to be unable to locate the testicles. The testicle is normal in this case, but it is pulled back out of the scrotum by a muscle reflex. Because the testicles are still small before puberty, this is possible. The testicles will naturally descend during puberty, and surgery is not required.

Abnormal testicles are those that do not naturally descend into the scrotum. Even if it is surgically brought into the scrotum, an undescended testicle is more likely to develop cancer. Cancer is more likely in the other testicle as well.

Bringing the testicle into the scrotum can improve sperm production and increase fertility chances. It also enables the provider to perform a cancer screening exam. In other cases, even during surgery, no testicle is discovered. This could be the result of an issue that occurred while the baby was still developing before birth.

Symptoms:

Other than the absence of the testicle in the scrotum, there are usually no symptoms. (This is known as an empty scrotum.)

Diagnosis:

A provider exam confirms that one or both testicles are not in the scrotum. The undescended testicle in the abdominal wall above the scrotum may or may not be felt by the provider. Imaging tests like an ultrasound or a CT scan may be performed.

Treatment:

In most cases, the testicle will fall out without treatment during the first year of a child's life. If this does not happen, treatment options may include:

Injections of hormones
(B-HCG or testosterone) to try to move the testicle into the scrotum.
The testicle is brought into the scrotum via surgery (orchiopexy). This is the primary therapy.

Early surgery may help to prevent testicular damage and infertility. If an undescended testicle is discovered later in life, it may need to be removed. This is due to the fact that the testicle is unlikely to function properly and may pose a risk of cancer.

Things to remember

An undescended testicle (cryptorchidism) is one that has not moved down into the scrotum and has remained inside the body.
It is possible that one or both testicles will be affected.
A boy's testicles usually descend by the time he is 9 months old. Undescended testicles are fairly common in premature infants.
In full-term infants, the problem is less common.
Some babies have retractile testes, which causes the health care provider to be unable to locate the testicles. The testicle is normal in this case, but it is pulled back out of the scrotum by a muscle reflex.
Other than the absence of the testicle in the scrotum, there are usually no symptoms.
In most cases, the testicle will fall out without treatment during the first year of a child's life.
If this does not happen, treatment may include hormone injections as well as surgery (orchiopexy) to move the testicle into the scrotum.

Questions and Answers

Define Undescended testicles and also write about its classification ?

A testicle that is still inside the body and hasn't descended into the scrotum is referred to as an undescended testicle (cryptorchidism). Affected testicles could be either one or both. Undescended testicles are frequently categorized based on where they are and whether they are palpable.

Abdominal: During a physical examination, the testicle is still inside the abdomen and is not perceptible. It typically lies close to the inguinal canal's inner opening.
Testicle stops in the inguinal canal, where it is typically difficult to feel during a physical examination.
The testicle descends further down the inguinal canal but does not reach the scrotum, a condition known as prescrotal or prepubic. Typically, it is palpable (can be felt) during a physical examination.

What are the causes of undescended testes ?

By the time he is 9 months old, a boy's testicles typically descend. In newborns who are delivered early, undescended testicles are pretty typical. Full-term infants are less likely to experience the issue. Retractile testes is a problem that affects some infants, and the doctor might not be able to locate the testicles. The testicle in this instance is normal, but a muscle reflex causes it to be pulled back out of the scrotum. Because the testicles are still small before puberty, this is possible. At puberty, the testicles will naturally descend, so surgery is not required. It is abnormal for the testicles to not fall into the scrotum spontaneously. Even if a testicle is surgically placed into the scrotum, it is more likely to develop cancer if it remains undescended. In the other testicle, cancer is likewise more likely to develop. The likelihood of successful conception can be improved by inserting the testicle into the scrotum. The doctor can perform an examination for the purpose of finding cancer early. Other times, even during surgery, there might be no sign of a testicle. This might be a result of an issue that cropped up while the baby was still forming before birth.

What are the common methods of treatment ?

In the majority of cases, throughout the first year of life, the testicles will fall out naturally. If not, the following treatments might be used:

B-HCG or testosterone injections are used to try and move the testicle into the scrotum.
Surgery to move the testicle into the scrotum (orchiopexy). The primary therapy is this.

Early surgery could prevent testicular injury and prevent infertility. Later in life, if an undescended testicle is discovered, it might need to be removed. This is due to the testicle's likely poor function and potential for cancer.