Undescended Testicle
- Where Are the Normal Locations of the Oocytes (Eggs) Before and After Birth?
- What Is a Retractile (Shy) Testis?
- If the Test Doesn't Come Back, What Could Be the Reason?
- How Is an Undescended Testicle Diagnosed?
- Will an Unresolved Test Cause Problems Later On?
- Is Surgery the Only Treatment for an Undescended Testicle?
Where Are the Normal Locations of the Oocytes (Eggs) Before and After Birth?
Before male babies are born, both testicles are located in the baby’s abdominal cavity. As the baby continues to develop in the womb, the testicles begin to descend into the scrotum. After leaving the abdominal cavity, they pass through the groin area and settle into the scrotum shortly before birth. In rare cases, this descent into the scrotum may continue during the first 6 months after birth. If the testicles are not in the scrotum in a newborn baby, this condition is called true undescended testicle. Some undescended testicles descend on their own by the end of the first 6 months. After that, this condition must be treated. It usually occurs on one side, but sometimes on both sides at once. The key characteristic of a true undescended testicle is that one or both testicles cannot be felt in the scrotum.
What Is a Retractile (Shy) Testis?
This condition is different from the one described above. The testicles are sometimes visible in the scrotum. However, they sometimes retreat toward the groin and disappear. The approach to this condition differs from that for an undescended testicle.
If the Test Doesn't Come Back, What Could Be the Reason?
After forming inside the abdomen, the testicle may have stopped descending. It may have become stuck in the inguinal canal and failed to descend into the scrotum. It may not have even begun to descend at all and may have remained inside the abdomen. Sometimes the testicle may be completely absent. This is because the testicle twists around itself, blocking blood flow, and eventually withers away due to lack of nourishment.
How Is an Undescended Testicle Diagnosed?
A physical examination alone is sufficient for the majority of patients. The testicle can be felt. However, in 20 percent of patients, the testicle cannot be felt. Testicles that cannot be felt are either absent, as described above, or are located inside the abdomen and therefore cannot be felt during a groin examination. In this case, imaging methods such as ultrasound or MRI are not necessary. Laparoscopy is performed to distinguish between these two conditions. It involves inserting a thin camera through an incision in the abdominal wall to visualize the abdominal cavity.
Will an Unresolved Test Cause Problems Later On?
If left untreated, yes, it will cause problems in the future. It reduces the chances of having children later in life. The earlier the testicles descend into the scrotum, the lower this risk becomes. Additionally, unfortunately, the rate of cancer development in these testicles is higher. However, bringing the testicles down does not reduce this risk. It causes cosmetic issues and related psychological problems.
How Long Should I Wait to Seek Treatment for an Unresolved Test?
According to the modern approach, treatment should be performed between 6 months and 1 year of age. If there is also a hernia on the side with the undescended testicle, surgical treatment should be performed without delay—even in a 1-month-old infant, if necessary.
Is Surgery the Only Treatment for an Undescended Testicle?
Surgery is the most common and definitive treatment method. The success rate is very high. During surgery, after the testicle is exposed, the inguinal hernia—a common problem in many patients with undescended testicles—is also corrected; the blood vessels supplying the testicle are separated from adhesions to the surrounding tissues and lengthened. The testicle is then secured inside the scrotum with sutures. In some cases, hormone therapy
may be administered. It should be used only in carefully selected patients, and the side effects must be explained. The success rate is low.
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