Normally, the testicles of newborn male babies should be in the scrotum (colloquially known as the bags).
What is Undescended Testicles?
If one or both If two testicles have not descended into the scrotum, this condition is called undescended testicle.
The equivalent in medical language is 'Cryptorchidism', a word of Greek origin. This has a slightly more general meaning and includes the testicles not developing at all or developing and moving to a different place (ectopic testicle).
Undescended testicle is one of the most common congenital problems in boys, approximately in every 100 boys born. It can be seen in 3-4 babies. This rate is reported to be 0.8-1.0% in children who have completed one year of age.
35-45 percent of Undescended Testis cases may descend spontaneously within the first 3-6 months after birth.
Undescended testicle. The incidence has a close relationship with the week of birth and weight.
The most important risk factors known today that may lead to undescended testicles are premature birth and, more importantly, low birth weight.
Those born at or below 1500 grams. Its incidence in boys reaches 60-70 percent.
In premature babies, this rate can rise up to 35 percent.
What problems can undescended testicles cause?
The most important point about undescended testicles is the risk of affecting the male baby's future ability to have children (infertility). In addition, the risk of testicular cancer is higher than normal in these babies. The risk of undescended testicles turning around and strangulation (torsion) is increased compared to normal. In babies whose testicles do not descend, there is a risk that the inguinal canal may remain open and a hernia may develop. In addition, the testicles remaining in the inguinal canal are more susceptible to trauma (impacts).
Finally, the negative psychological effects of the testicle not being in the scrotum, that is, an empty scrotum, will have on that child in the future should not be ignored.
In cases with undescended testicles, In 80% of cases, the testicle is palpable in the inguinal canal or in a different location.
During the examination, the inguinal region, femoral region, perineum and opposite scrotum are carefully examined. The palpated testicle moves from the inguinal canal towards the scrotum. is patted. If the testicle can be lowered into the scrotum upon examination and continues to remain in the scrotum for a while when released, it is considered a retractile testicle (shy testicle).
One-sided undescended. In testicular cases, seeing the opposite testicle larger than normal, that is, hypertrophic, suggests that the testicle on that side may be atrophic.
In cases that cannot be palpated or found in any way, there is a possibility that the testicle is left in the abdomen. In this case, since no imaging method (including MRI) will have sufficient reliability, the most appropriate approach is to investigate the inside of the abdomen using very thin optical instruments (laparoscopy).
In 30% of undescended testicle patients, the problem is bilateral (on both sides).
Patients with bilateral non-palpable testicles and serious problems with the penis, such as micropenis or hypospadias, are considered to have suspicious genital structure.
Such patients are consulted with pediatric endocrinologists. It is necessary to be evaluated and hormone analyzes and chromosome analyzes should be performed.
Treatment of Undescended Testicles
Since the testicles that are not in place at birth may descend on their own after birth, the testicles It may be necessary to wait a while for lowering surgery. Here the maximum waiting limit is the first age. If the testicle has not descended by the first age, it must be removed surgically by performing a testicular reduction surgery. Apart from testicle lowering surgery, there are also some hormone treatments.
Delay in undescended testicle surgery may lead to very serious irreversible problems
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