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Undescended testicle(cryptorchidism)
Definition
Undescended testicle (cryptorchidism) is a testicle that hasn't moved into itsproper position in the bag of skin hanging behind the penis (scrotum) prior to thebirth of a baby boy.About 2 to 5 percent of baby boys are born with one or two undescendedtesticles. An undescended testicle is more common among baby boys bornprematurely, or before 37 weeks. It's rare for boys with cryptorchidism to havetwo undescended testicles.For most boys born with one or two undescended testicles, the problem correctsitself within the first few months of life. If your infant has an undescended testiclethat doesn't correct itself, surgery can usually be used to relocate it into thescrotum.
Symptoms
Testicles form in the abdomen during fetal development. During the last coupleof months of normal fetal development, the testicles gradually leave theabdomen, pass through a tube-like passageway in the groin (inguinal canal) anddescend into the scrotum.If your son has an undescended testicle, that process was stopped or delayed insome stage of development. Therefore, you won't see or feel a testicle whereyou would expect it to be in the scrotum.
When to see a doctor
An undescended testicle is typically detected when your baby is examinedshortly after birth. If your son has an undescended testicle, ask the doctor howoften your son will need to be examined. If the testicle hasn't moved into thescrotum by the time your son is 4 months old, the problem probably won't correctitself. Treating undescended testicle when your son is still a baby may lower therisk of complications later in life, such as infertility and testicular cancer.Older boys — from infants to preadolescent boys — who have normallydescended testicles at birth may appear to be "missing" a testicle later. Thiscondition may indicate:
•
A
retractile testicle,
which moves back and forth between the scrotumand the groin and may be easily guided by hand into the scrotum during aphysical examination
•
An
ascending testicle,
or acquired undescended testicle, which has"returned" to the groin and cannot be easily guided by hand into thescrotumIf you notice any changes in your son's genitals or are concerned about hisdevelopment, talk to your doctor.
Causes
The exact cause of an undescended testicle isn't known. A combination ofgenetics, maternal health and other environmental factors may disrupt thehormones, physical changes and nerve activity that influence the development ofthe testicles.
Risk factors
Low birth weight and premature birth are the best understood risk factors thatmay increase the likelihood of undescended testicle in a newborn. Other riskfactors are not as well understood. Conditions that may increase the risk include:
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Low birth weight
•
Premature birth
•
Family history of undescended testicle or other problems of genitaldevelopment
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Conditions of the fetus that can restrict growth, such as Down syndromeor an abdominal wall defect
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Alcohol use by the mother during pregnancy
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Cigarette smoking by mother or exposure to secondhand smoke
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Diabetes in the mother — type 1 diabetes, type 2 diabetes or gestationaldiabetes
•
Parents' exposure to some pesticides
Complications
In order for testicles to develop and function normally, they need to be slightlycooler than normal body temperature. The scrotum provides this coolerenvironment. Until a boy is 3 or 4 years old, the testicles undergo changes thataffect how well they function later.An undescended testicle isn't in a cooler environment. This might increase therisk of complications later in life. These complications include:
•
Testicular cancer.
Testicular cancer usually begins in the cells in thetesticle that produce immature sperm. What causes these cells to developinto cancer is unknown. Men who've had an undescended testicle have anincreased risk of testicular cancer.
•
Fertility problems.
Low sperm counts, poor sperm quality and impairedfertility are more likely to occur among men who have had anundescended testicle.Other complications related to the abnormal location of the undescended testicleinclude:
•
Testicular torsion.
Testicular torsion is the twisting of the spermatic cord,which contains blood vessels, nerves and the tube that carries semenfrom the testicle to the penis. This painful condition cuts off blood to thetesticle. If not treated promptly, it may result in the loss of the testicle. Anundescended testicle increases the risk of testicular torsion.
•
Trauma.
If a testicle is located in the groin, it may be damaged frompressure against the pubic bone.
•
Inguinal hernia.
An undescended testicle may be associated with aninguinal hernia. If the opening between the abdomen and the inguinalcanal is too loose, a portion of the intestines can push into the groin.
Preparing for your appointment
An undescended testicle is usually detected at birth. Therefore, your familydoctor or pediatrician will continue to monitor the condition during regularlyscheduled examinations, or well-baby visits, for your infant son. Becauseappointments can be brief and there are often a number of questions to addressduring infant checkups, it's a good idea to be well prepared for your appointment.Write down a list of questions to discuss with your doctor. Questions regardingan undescended testicle might include:
•
How often should we schedule appointments?
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How can I safely examine the scrotum at home to monitor any changes inthe undescended testicle?
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When would you recommend seeing a specialist?
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What kinds of tests will my son need?
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What treatment options do you recommend?
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Are there any brochures or other printed material that I can take homewith me? What Web sites do you recommend visiting?The best time to your ask questions is at the beginning of the appointment, butdon't hesitate to ask additional questions during your appointment at any timethat you don't understand something.
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Undescended Testicle Crypt Orchid Ism)
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| Upload Date: | 04/24/2009 |
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