- What is undescended testicle?
- What are the causes of undescended testicle?
- What are the treatment methods?
During the intrauterine period, the testicle is inside the child's abdomen, then passes through the inguinal canal and descends into the scrotum. If this descent does not occur, a condition called "undescended testicle" occurs. The reason is often that the vein of the testicle is short, the structure called gubernaculum, which directs the testicle downward, is insufficient or directed to the wrong place. There are also hormonal factors involved. In this case, both testicles usually do not descend.
What Are the Consequences of Undescended Testicles?
The results of undescended testicles are extremely important. Like this; The temperature in the inguinal canal or abdominal area is 1.5-2 degrees higher than the temperature in the scrotum. For this reason, testicular tissue exposed to heat deteriorates. Just as chicken eggs deteriorate after a while when left in the heat, the same situation applies here. Deteriorated testicular tissue loses its ability to produce sperm over time. As a result, the number and quality of sperm are affected, and the more the testicle is exposed to heat, the more likely it is to cause infertility, that is, the inability to have children. The risk of infertility increases. The second result is that the probability of developing testicular cancer from this testicle in adulthood increases significantly compared to normal.
What should be the Treatment Approach?
Unilateral The treatment of undescended testicle is definitely surgical. Hormone therapy has no place in the treatment of unilateral undescended testicles. Hormone therapy can be tried in bilateral undescended testicles.
The age for surgery is after 6 months, but it should not be delayed until after 1 year. If the child does not have another disease that would prevent undescended testicle surgery, or if he does not have any problems such as upper respiratory tract infection or anemia that would delay anesthesia, he should be operated on as soon as possible. After 5-6 hours of fasting, the testicle can be removed with an approximately 1-hour surgery. It is a day surgery.
If the testicle is palpable in the inguinal canal during the examination, the surgery is performed with a 2 cm incision made horizontally in the groin area, above the crease also called the panty line. ka The testicle is freed by finding it in the narrow canal and is detected by lowering it into the scrotum (bag). However, sometimes the shortness of the vein does not allow it to descend completely, in which case the testicle can be lowered as much as possible and after a while, assuming that the vein has lengthened, it can be operated on again. Sometimes the testicle may atrophy and the removed tissue may remain very small and it will be difficult for the doctor to explain to the family that he has removed the testicle...
If the testicle is not palpable during examination, it is first necessary to have an ultrasound of the abdominal and scrotal region. As a result, if the testicle is not palpable, it is either in the abdomen or it has become too small to be palpable and cannot be detected on ultrasound.
In palpable testicles, the undescended testicle must be investigated laparoscopically (closed method). In the laparoscopic examination of the testicle in the abdomen, if the testicle is found in the abdomen and its location and size are suitable, it is pushed into the inguinal canal and removed with open surgery. There may be no testicle in the abdomen (anorchia). Or the testicle found is too small. In this case, testicular tissue must be removed to prevent future cancer formation (Orchiectomy). If the testicular vessels and spermatic cord are seen to enter the inguinal canal during laparoscopy, it is usually seen that the vessels and spermatic cord are hypoplastic (underdeveloped). In this case, we understand that the testicle has descended, but has fused because it cannot feed. The remaining testicle tissue should be removed through an incision made in the inguinal canal.
What should be done for the testicle that sometimes goes down and sometimes goes up?
This situation is called Shy (retractile) Testis. It is difficult to decide. It should be monitored how long the testicle remains in the scrotum and how long it moves up. In particular, the diaper should be uncovered and examined while the child is sleeping at night, and it should be examined during the day. As a result, when we are faced with a testicle that descends into the scrotum for more than half of 24 hours, it will be sufficient to detect the testicle with an incision made on the scrotum rather than through the inguinal canal.
Read: 0
