Most people have never heard of undescended testes, also called cryptorchidism. But, the condition is more common than most people think. So what exactly are undescended testicles, and why does it occur? Keep reading to learn more.
What Are Undescended Testes?
The condition where testes are not in the scrotum (the sac outside the body) is known as cryptorchidism. In most instances, both testicles start life in the abdomen and then descend into the scrotum. However, sometimes one or both of the testicles fail to make this journey which can cause fertility issues and a host of other potential symptoms/complications.
Usually diagnosed at birth, undescended testes can occasionally develop later in childhood. In some cases, the testicles may descend spontaneously, but in most cases requiring surgical intervention to correct the problem.
Although doctors can often correct cryptorchidism with surgery, there is a risk that the condition may recur. In addition, an increased risk of testicular cancer has a link to cryptorchidism. For these reasons, it is crucial to monitor boys with cryptorchidism closely.
Doctors often recommend surgery if the testicles have not descended by age 13. However, in some cases, surgery may be delayed until adulthood.
What Causes Undescended Testes?
While the exact cause of undescended testes is unknown, it seems to relate to abnormal development of the testicles and surrounding tissues in the womb. In most cases, only one testicle is affected. However, in some cases, both testicles may be affected.
It could be due to genetic and environmental factors. Testosterone plays an important role in the development of the reproductive system, and studies have shown that exposure to high levels of testosterone in utero can lead to undescended testes. In addition, certain genetic conditions, such as Klinefelter syndrome, have been linked to an increased risk of cryptorchidism.
Sleeping baby boy | Image Source: iStock
What Are the Symptoms of UDT in Children and Adults?
Many symptoms may be associated with undescended testicles. Sometimes, the affected testicle can be felt in the inguinal canal. It’s the passageway between the abdomen and the scrotum.
In other cases, the testicle may be located higher up in the abdomen and unable to be felt. In either case, there may be no obvious visible signs of cryptorchidism. However, if both testicles are affected, the scrotum will appear empty. Other potential symptoms include pain or tenderness in the groin area and abnormal puberty development.
Undescended testes can occur on one or both sides. And the affected testicle may be partially or wholly undescended. Symptoms of undescended testes also include:
Painless Enlargement of the Abdomen
One symptom of undescended testes is a painless enlargement of the abdomen. It results from the accumulation of fluid in the abdomen, which can increase pressure on the surrounding organs.
Inguinal Hernias
An inguinal hernia occurs when the testicles haven’t descended into the scrotum and remain in the abdomen. Inguinal hernias can cause a bulge in the groin area and may be painful when your child stands or coughs.
Difficulty Urinating
One of its symptoms in children is difficulty urinating. It’s because the urethra is in front of the testicle. The tube carries urine from the bladder out of the body.
The scrotum is the proper location of the testicle. With that, urine can flow freely. However, when the testicle is undescended, it can block the urethra and cause difficulty urinating.
Difficulty Ejaculating
One symptom of undescended testes in adults is difficulty ejaculating. The testes cannot descend into the scrotum, which is its normal location. As a result, the testes cannot produce enough semen. In addition, the testicles may have an abnormal position, which can interfere with sexual function.
Change in the Position of the Penis
The penis may be angled downward, to the side, or positioned higher up on the abdomen than usual. In some cases, the testicles may also be small and firm. If you experience any of these changes, you must see a doctor as soon as possible.
While undescended testes are usually not a cause for concern, they can occasionally lead to fertility problems or an increased risk of testicular cancer.
How to Check for Undescended Testicle?
It is essential to check for undescended testicles as part of a routine physical examination. The procedure is simple and only takes a few minutes. The doctor will feel both sides of the scrotum for lumps or bumps. It may be undescended if you or the doctor cannot feel the testicle. Further testing, such as an ultrasound, helps confirm the diagnosis.
What’s the Risk of Undescended Testes?
Father massaging the baby
Here are the potential risks associated with undescended testes, including:
Decreased Fertility
Undescended testes are a risk factor for infertility, as they are more likely to have damage or abnormal hormone production.
An Increased Risk of Testicular Cancer
Some associate undescended testes with an increased risk of testicular cancer. The exact reason for this link is unclear, but the abnormal development of the testes may play a role.
Undescended testes are also more likely to experience high temperatures, damaging sperm production. For these reasons, it is essential to monitor infants with undescended testes closely and consider surgical intervention if necessary.
An Increased Risk of Painful Twisting of the Testes (Testicular Torsion)
Testicular torsion is a condition in which the spermatic cord, which provides blood flow to the testicle, becomes twisted. It usually occurs in adolescents. Testicular torsion is a medical emergency that can lead to the loss of the testicle if not treated promptly.
The risk of testicular torsion increases in males with undescended testes. Testicular torsion is associated with pain, swelling, and redness of the affected testicle.
An Increased Risk of Injury to the Testes
One of the risks associated with undescended testes is the potential for long-term damage to the testicles. It is because undescended testes are more susceptible to trauma and temperature changes than testes adequately positioned in the scrotum.
An Increased Risk of Infection in the Testes or Surrounding Tissues
Talk to his doctor if you’re concerned that your son may have undescended testes. Prompt treatment can help minimise potential complications.
When to See a Doctor?
Usually, undescended testes descend by the time a baby is six months old. If they don’t, your baby will need to see a doctor. The earlier the treatment, the better.
If treatment delays prolonged, the chance that the testes will not be able to produce sperm when your son reaches puberty increases. If not treated, there is also an increased risk of testicular cancer if undescended testes.
Your son’s doctor will likely recommend surgery to correct the problem.
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What is the Treatment for Undescended Testes?
Depending on the patient’s age, there are several different treatment options available for undescended testicles. In infants, the most common approach is to wait and see if the testicles eventually descend independently.
It usually happens within the first few months of life. There will be surgery if the testicles have not descended by the time the child is four or five years old. For adults, surgery is generally the preferred option.
The goal of surgery is to reposition the testicles into the scrotum. The surgery involves a small incision in the groin area. In some cases, additional procedures may be necessary to support the testicles in their new position.
With proper treatment, most patients with undescended testes can expect to have normal sexual function and fertility.
How Can You Prevent Undescended Testes in Your Child or Yourself?
There are several ways to prevent undescended testes in your child or yourself. The most important way is to have regular checkups with your doctor, starting at birth. Early diagnosis for cryptorchidism includes hormone therapy or surgery.
Another way to prevent undescended testes is to avoid exposure to harmful chemicals, such as those in cigarette smoke.
Finally, you can help to prevent undescended testes by maintaining a healthy lifestyle and being aware of your family history. If you have a family member with cryptorchidism, you may be at higher risk for the condition. Talk to your doctor about ways to reduce your risk.
Baby being readied for undescended testes checkup
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