Undescended testicle is a congenital condition most common in boys, characterized by the testicle not being palpable within the scrotum (bag). Undescended testicle is the absence of unilateral or bilateral testicles in the bag during examinations performed from the day of birth.
Undescended testicle is seen in 0.8-1% of 1-year-olds. It is more common in babies born prematurely or with low birth weight. Undescended testicles are seen bilaterally in one-third of the cases.
Undescended testicles
Undescended testicles are testicles that cannot be held steadily in the scrotum, cannot be lowered into the scrotum, and cause pain when lowered.
Retractile testicle. (shy testicle)
Retractile testicle is a variant of the normal testicle and is defined as the testicle that spontaneously comes out of the scrotum and returns to the scrotum spontaneously and can remain in the scrotum for a certain period of time. It can sometimes be difficult to distinguish a retractile testicle from an undescended testicle.
Diagnosis
What is important in diagnosis is the history and physical examination given by the family. Imaging methods to determine the localization of the testicles do not have any additional contribution.
Ultrasonography will not have any additional benefit. Patients with bilateral non-palpable testicles require genetic and endocrinological investigation.
Imaging studies
Imaging methods do not indicate with certainty whether testicles are present or not. Ultrasound and magnetic resonance imaging methods can be used for imaging. Although ultrasonography and magnetic resonance are non-invasive, they are costly, time-consuming and have low accuracy. Additionally, magnetic resonance imaging can be performed under anesthesia. This will cause most patients going to surgery to receive anesthesia a second time. Computed tomography is not requested to avoid radiation damage.
Treatment
As soon as the diagnosis of undescended testicle is made, surgery should be performed as soon as possible (starting from 6 months of age). The aim here is to increase the chance of adequate hormone production and protect future fertility (the ability to have children), to prevent unnecessary imaging studies, to reduce the family's anxiety, to repair any simultaneous hernia, to repair abdominal pain. To prevent future malignancy (turning into a malignant tumor) by an overlooked testicle and to prevent psychological damage by placing it in the scrotum and keeping it in normal anatomy.
Treatment should start from 6 months of age. The intervention to lower the testicles should be completed within 12 months, and within 18 months at the latest.
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