Undescended testicle

What is it?

Undescended testis is a condition in which one or both testes do not lie in the scrotum, the loose bag of skin below the penis. It is a common condition that occurs in nearly 4% of all newborn babies. The testes originally develop in the back of the abdominal cavity of the foetus. Later they begin to descend to the scrotum. If the testis fails to descend all the way down and gets stuck somewhere along the path of descent it is called an undescended testes. This process of descent occurs during late pregnancy. This is why 30% of premature babies have at least one undescended testes. Some of the testes may descend even after birth, but this usually happens in the first 3-4 months. Testes that do not descend till one year will not descend and need to be treated.

How is the diagnosis made?

The diagnosis is usually apparent. One or both testes may be missing from the scrotum. The condition, however, needs to be differentiated from retractile testis. Sometimes the testes move up and down depending on the temperature of the surroundings. If the child is in a warm bath his testes are normal, but if he is exposed to cold or stroked along his upper thigh, the testes move up towards the abdomen. This up and down movement is normal and these testes are called retractile testes. They do not require any treatment.The paediatric surgeon or urologist will be easily able to differentiate between a retractile testis and a true undescended testis. By examining the child he will also be able to locate the position of the undescended testis. Tests like ultrasound scan or CT scan to locate the testes are rarely required and are not very helpful. If the testis is not felt on repeated examination, the doctor may advise a laparoscopy examination to determine whether or not the testis is present in the abdomen. Sometimes testes can reach some place other than scrotum, a condition called ectopic testes. On examination, it is important to differentiate between undescended or atrophic testis, in latter condition, the testis is very small and can be difficult to feel.

What is the treatment?

It is very important for the boy's psyche to have two normal testes in the scrotum. This is often an underplayed argument. Testes require a temperature slightly lower than the body temperature for sperm production. If they lie too close to the body, then over time the cells that produce sperms die leading to infertility. To minimize this damage undescended testes need to be brought down to the scrotum by 6 months of age. Undescended testis are often associated with a hernia which requires surgical correction. If the testes remain in the abdomen for a long time, they have a slightly higher chance of developing a cancer. If testis is in groin area, it is more easily injured during play or accidents.

Ajay Sharma#/doctor/ajay-sharma-108618#108618#Entity Anurag Krishna#/doctor/anurag-krishna-108581#108581#Entity

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