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Paediatric undescended testicles

OVERVIEW

Undescended testicles, medically referred to as cryptorchidism, are a condition characterised by one or both testicles failing to descend into the scrotum during foetal development. Normally, testicles form in the abdomen and gradually move down into the scrotum before birth or within the first few months of life.

In cases of undescended testicles, one or both testicles may remain in the abdomen or in the inguinal canal (the passage that the testicles travel through to reach the scrotum). The condition is most commonly seen in premature babies, but it can also occur in full-term infants, and boys can be seen at any age with this condition.

Undescended testicles can cause fertility problems and increase the risk of testicular cancer later in life if not treated. Therefore, medical attention should be sought if the condition is suspected.

Symptoms of undescended testicles

In most cases, undescended testicles do not cause any noticeable symptoms. The main sign of the condition is the absence of one or both testicles from the scrotum. However, in some cases, an undescended testicle may be felt in the groin or the abdomen.

Other symptoms may include the following:

Inguinal hernia: An inguinal hernia can be indicated by the presence of a bulge in the groin or scrotum. This condition occurs when a piece of the intestine protrudes through a weakened area in the abdominal muscles.
Testicular torsion: When a testicle is not in its proper position, it is at higher risk of twisting around its own blood supply, a condition called testicular torsion. This can cause severe pain and requires immediate medical attention.
Fertility problems: Undescended testicles can result in impaired fertility or infertility later in life.
Testicular cancer: Men who have had undescended testicles are at an increased susceptibility of developing testicular cancer.

Seeking medical attention for an accurate diagnosis and appropriate treatment is crucial if you suspect that you or your child has undescended testicles.

Treatment of undescended testicles

Surgical treatment is the most common approach for correcting undescended testicles, especially if the condition has not resolved on its own by the age of one. The surgical procedure is typically performed on an outpatient basis under general anaesthesia.

The goal of surgery is to bring the testicle down into the scrotum and anchor it there. A minor surgical procedure is performed to treat undescended testicles, which involves creating a small cut either in the groin or scrotum, depending on the position of the testicle. The surgeon then frees the testicle from any surrounding tissue and carefully pulls it down into the scrotum.

In some cases, the surgeon may need to create a small pouch in the scrotum to hold the testicle in place. After the testicle is properly positioned, the incision is closed with sutures or surgical glue.

The success rate of surgery for undescended testicles is high, with most cases resulting in the successful placement of the testicle in the scrotum. After surgery, the child will need to be monitored to ensure that the testicle remains in the correct position and that there are no complications from the procedure. Regular follow-up visits with a Paediatric surgeon are recommended.

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Dr Mangray, the founder of KZN Specialised Paediatric Surgical Service, and his associates, Dr Ngobese, Dr Govender and Dr Dube-Zvirikuzhe, have a well-established reputation for caring for children right until late adolescence.

FREQUENTLY ASKED QUESTIONS

FAQ

1Is surgery always necessary for undescended testicles?

Surgery is typically recommended for undescended testicles that do not correct themselves by the age of 6 months.

2What are the risks of surgery for undescended testicles?

Like any surgery, there are risks associated with surgery for undescended testicles, including bleeding, infection, and damage to surrounding tissue. However, the risks are generally low.

3Is there anything parents can do to prevent undescended testicles?

There is no known way to prevent undescended testicles from occurring. However, the probability of developing the condition may increase due to certain risk factors such as low birth weight, premature birth, or a family history of the condition.