Program: B.Sc.

Nursing, V Semester, Third Year

BNSG502 : Child Health Nursing
Unit No - 5
Unit Name - Nursing Management in Common
Childhood Diseases

Topic Name- CRYPTORCHIDISM

Lecture No.- 28
Mr. Ravi Rai Dangi
Assistant Professor, SONS

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Outlines
• Introduction
• Definition
• Etiology
• Clinical manifestation
• Diagnostic investigation
• Management
• Exercise
• Learning outcome
• References

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 Introduction
An undescended testicle (cryptorchidism) is a testicle that hasn't moved
into its proper position in the bag of skin hanging below the penis
(scrotum) before birth. Usually just one testicle is affected, but about 10
percent of the time both testicles are undescended.

The vast majority of the time, the undescended testicle moves into the
proper position on its own, within the first few months of life.

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 Definition
It is a condition seen in newborns when one or both of the male testes
have not passed down into the scrotal sac.

An undescended testicle is uncommon in general, but common among

baby boys born prematurely.

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 Types

• True undescended testis:

where testis is absent from the scrotum but lies
along the line of testicular descent.

• Ectopic testis:
where the testis is found away from the normal
path of decent.

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 Causes & Risk Factor
• Prematurity is a leading cause, other causes may include

• Hormonal disorders

• Spina bifida

• Retractile testes

• Testicular absence

• Low birth weight

• Premature birth

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 Causes & Risk Factor

• Family history of undescended testicles or other problems of genital

development

• Conditions of the fetus that can restrict growth, such as Down syndrome or
an abdominal wall defect

• Alcohol use by the mother during pregnancy

• Cigarette smoking by the mother or exposure to secondhand smoke

• Parents' exposure to some pesticides

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 Symptoms

• A non-palpable testis

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 Diagnosis
• Physical examination

• Ultrasound

• X-ray

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 Management
• Undescended testes usually resolves without any intervention by the time
that the infant is 6 months old.

• Surgical Repair

• Hormonal therapy

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 Surgical Repair
• The testicle won't drop after 3 months of age, so the only treatment choice is
surgery. Surgery is recommended after 6 months of age. The timing takes into
account when the child is able to handle anesthesia and the surgery. Drugs or
hormone treatment aren't useful.

• This surgery is called an orchiopexy. A cut about 1 inch long is made in the
groin area. The testicles is freed from all nearby tissues so that it moves easily
into the scrotum. Then it is stitched into place. If there's a hernia, it's fixed at
the same time. In some cases, the testicle is too high for this simple surgery. If
this is the case, more complex methods (and sometimes even 2 surgeries) are
needed. Overall, the success rate with surgery is 98 out of 100.

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 After Treatment
• After treatment, the testicle often grows to normal size in the scrotum. In some
cases, the testicle wasn't normal to start with, and never grows the right way. In
other cases, sperm never grow, even though the testicle size is normal.

• In most cases, after treatment for 1 undescended testicle, fertility becomes

normal and the chances of fathering a child in the future are high. When the
child becomes a teen, he should have routine physical exams and do monthly
testicular examination. Routine physicals will look for signs of testicular
cancer, which remains a slight risk.

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 Management
Hormonal therapy

Hormone treatment involves the injection of human chorionic

gonadotropin (HCG). This hormone could cause the testicle to move to your son's
scrotum. Hormone treatment is not usually recommended because it is much less
effective than surgery.

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 Management
Homecare After Surgical Repair

• Pain Management

• Care for Dressings

• Swelling After Surgery

• Bathing Restrictions

• Activity Restrictions

• Follow – up

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 Nursing Management
Assessment-

• Assessment and document the condition of the patient

• Collect history
• Conduct physical examination
• Monitor urine output and fluid intake
• Check body weight
• Check laboratory investigations
• Assess the anxiety of parents and child

All pre and post operative care is necessary.

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 Complications
• Infertility

• Risk of testicular cancer increases considerably by age 30 or 40

• Inguinal hernia

• Testicular torsion

• Psychological consequences of an empty scrotum

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 Exercise
• Write down the nursing management of cryptorchidism.

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 Learning Outcomes
The student will be able to explain following:-

• Explain the cryptorchidism.

• Discuss the etiology and clinical manifestations.
• Explain the management.

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 References

1. Whaley & Wongs , Essential of Pediatric Nursing , 5th Edition, Mosby

Publisher.

2. Parul Datta, Pediatric Nursing, 3rd Edition, Jaypee Brothers Medical

Publishers Pvt Ltd.

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SELO

2. Clear understanding of professional ethics.

4. Lifelong learning ability.

8. Ability to understand subject related concepts clearly along with

contemporary issues.

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