Undescended testis, medically known as cryptorchidism, is a condition that occurs when one or both testes fail to descend into the scrotum before birth. This condition affects approximately 3-5% of full-term male infants and up to 30% of premature male infants. While it may not initially seem like a significant concern, undescended testis can have long-term implications if left untreated. In this blog post, we’ll delve into the causes, effects, and treatment options for undescended testis.
Causes: The descent of the testes from the abdomen into the scrotum usually occurs during fetal development. However, in cases of undescended testis, this process is interrupted for various reasons, including:
- Hormonal Factors: Testosterone plays a crucial role in the descent of the testes. Any hormonal imbalance during fetal development can affect this process.
- Anatomical Factors: Structural abnormalities in the inguinal canal or abnormalities in the gubernaculum (the structure that helps guide the testes into the scrotum) can impede testicular descent.
- Premature Birth: Premature infants are more likely to have undescended testes due to incomplete development before birth.
Effects: While undescended testis may not cause immediate discomfort or symptoms, it can lead to several long-term complications if left untreated, including:
- Infertility: Undescended testis increases the risk of infertility later in life, primarily due to impaired sperm production and function.
- Testicular Cancer: Individuals with undescended testis have a higher risk of developing testicular cancer compared to those with normally descended testes.
- Testicular Torsion: Undescended testis increases the risk of testicular torsion, a painful condition where the testicle twists on its spermatic cord, cutting off blood flow.
Treatment Options: The primary goal of treating undescended testis is to facilitate the descent of the testicle(s) into the scrotum to prevent long-term complications. Treatment options include:
- Observation: In some cases, especially if the undescended testis is likely to descend on its own within the first few months of life, a “wait-and-see” approach may be recommended.
- Hormonal Therapy: Hormonal treatment using human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone (GnRH) can sometimes stimulate testicular descent, particularly in cases of retractile testes.
- Surgery: Orchiopexy, a surgical procedure, is the most common treatment for undescended testis. During orchiopexy, the surgeon gently brings the undescended testis into the scrotum and secures it in place. This procedure is typically performed between 6 and 18 months of age to optimize outcomes.
Conclusion: Undescended testis is a relatively common condition in male infants, but it requires prompt attention to prevent potential long-term complications such as infertility, testicular cancer, and testicular torsion. Early diagnosis and appropriate treatment, whether through observation, hormonal therapy, or surgery, can significantly improve outcomes and minimize the risk of complications later in life. If you suspect that your child may have an undescended testis, consult a healthcare professional for evaluation and guidance.