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Undescended Testicle: Causes, Symptoms, Treatment

Undescended Testicle: Causes, Symptoms, Treatment

An undescended testicle is associated with either or both the testicles not having moved down the scrotum. In medical terminology, it is called cryptorchidism.

Stimulated by male hormones, the organs start developing as an integral part of the abdomen. At around 32 to 36 weeks of gestation of pregnancy, the testicles begin moving down through the abdominal cavity to the scrotum.

Some infants, especially prematurely born male infants, may be born with undescended or partially descended testicles. Most commonly, the condition affects the right testicle.

undescended testicle

In such cases, the testicles remain within the abdominal cavity or they may be found anywhere along the ‘path of descent’. It may also be struck high up in the retroperitoneal abdomen to the inguinal ring or in the abdomen.

In most of these cases, the testicles complete their descent within 6 months after birth. Another reason why the organs may not have descended is that their blood vessels may have got twisted or blocked before birth, causing the testicles to shrink.

In rare cases, an acquired undescended testicle may occur amongst boys between the ages of 4 and 10 years. This condition occurs when one or both the testicles move back up into the abdomen.

The reason behind such incidence is still debated and there are no conclusive reports behind this condition. It is believed that this occurs when the spermatic cord connected to the testicle does not keep up the pace of development as the rest of the body.

Cryptorchidism is a pathological condition characterised by comparatively small or underdeveloped testicles that do not descend into the scrotum. The condition may occur in one or both the testicles.

Symptoms of Undescended Testicle

The only apparent symptom of cryptorchidism is that the scrotum is underdeveloped or appears smaller than usual on either or both the sides. There is no pain. In rare cases, testicular torsion may occur. This condition is associated with twisted testicles that cause severe pain in the groin. It is a serious medical condition that requires emergency medical assistance.

Causes of Undescended Testicle

The causes of cryptorchidism are debatable. There is no conclusive report yet to establish the underlying cause behind the medical condition. It is believed that it may occur due to hormonal disturbance.

Risk Factors

The possible risk factors of undescended testicles are:

Age

The underdevelopment or other complications of either or both the testicles appear amongst infants between 1 to 6 months of age.

Environmental factors

Harmful environmental factors may affect gonadal development and embryonal programming during the foetal stage. It also increases the risk of testicular dysgenesis syndrome (TDS), which manifests through symptoms like cryptorchidism.

Diagnosis of Undescended Testicle

The diagnostic procedure of cryptorchidism includes physical investigation followed by lab tests and invasive surgery. Let’s take a closer look at the diagnostic process:

Physical inspection

Based on the symptoms explained to the doctor, he/she will undertake a thorough physical investigation of the newborn. The underdevelopment may also come to the notice of the child specialist during the regular paediatric visits.

Treatment is essential when either or both the testicles are in the groin, and cannot be brought down to the scrotum. To increase the chances of effective treatment for the medical condition, it should be ideally treated within a maximum of 1 year.

Diagnostic tests

Imaging tests like CT and MRI scans are likely to be recommended to evaluate the exact location of the undescended testis. An ultrasound test may also be advised to identify the flow of blood in the blood vessels of the relevant locations.

The position of the undescended testis can also be identified and/or confirmed through diagnostic laparoscopy.

For this procedure, some small incisions are made around the groin and a video camera is inserted through one of them. This helps in taking a close look at the area and identifying the exact location of the undescended testicle(s).

Treatment

The presence of undescended tesicle becomes apparent between the first 6 months in a newborn. If left untreated, it causes damage to the testicular cells, which are responsible for producing sperm in later life.

Hence, doctors usually recommend that this disorder be treated within a maximum of 2 years. This disorder can be treated through a surgical procedure called orchiopexy.

What happens during this surgery?

  • The undescended testicle surgery involves bringing down the testicle(s) from the abdomen or scrotum to its expected location through the abdominal opening.
  • The testicle(s) is then stitched in its place.
  • It is conducted under general anaesthesia and spans about 45 minutes. At times, two surgeries may have to be conducted in more complicated cases with a gap of 6 months.
  • In some cases, hormone injections may be administered before the undescended testicle surgery to stimulate the testicle(s) to produce increased quantities of testosterone. This may ease the process of bringing down the testicle(s).

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

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Written by Nikita Bhalla Updated Apr 03
Fact Checked by Hello Doctor Medical Panel
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