What happens under normal conditions?
Normal testicles arise early in a boy's development. Although they are
located initially in the abdominal cavity, they descend or drop into the
scrotal area during the latter part of pregnancy.
In response to the baby's normal hormones. The testicles in the infant
make sperm and the male sex hormone testosterone .The purpose of the
scrotum is to allow the testis to be in a cooler environment than the body,
because sperm cannot develop at body temperature.
During childhood, sperm in the testicles are undergoing a maturation
process that ultimately results in mature sperm at puberty. If the testicles
are undescended, meaning not in the scrotum, then the sperm do not
What causes undescended testes?
In most children with this condition it is not
known why the testicles fail to descend. It may be
because the testicles are not normal to start with.
In other cases there is a mechanical problem that
leads them to descend or drop but miss the
scrotum, and end up adjacent to the scrotum
these are called "ectopic testicles”.
It may be that the infant's hormones may be
insufficient to stimulate the testicles normally.
How do you diagnose undescended testes?
The most common diagnostic dilemma in otherwise
normal boys is distinguishing a retractile testis from
a testis that will not/cannot descend spontaneously
into the scrotum. Retractile testes are more
common than truly undescended testes and do not
need to be operated on.
Pelvic Ultrasound and MRI are used to locate the
undescended testes in the abdomen.
What are the Treatments that are available ?
Treatment is recommended anytime after six months
of age. The time between six and 18 months of age is
generally considered best, when taking into account
surgical and anesthetic factors.
The testis will not descend spontaneously after 3
months of age. Consequently, the only available
treatment option is surgery. This operation is called an
orchiopexy. It is done under general anesthesia, and
the baby can almost always go home the same day and
usually acts entirely normal within one to two days.
What are the Treatments that are available?
An incision about an inch long is made in the
groin area .The testicle is separated from all
surrounding tissues so that it comes easily into
the scrotum where it is stitched into place.
What can be expected after treatment ?
After treatment, the testicle usually develops
to normal size in the scrotum. However, in
some cases the testicle is abnormal to start
with and never grows properly.
It is recommended that, as a teenager, these
patients have regular physical examinations
and be reminded to perform monthly
testicular self-examination .
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