UNDECENDED TESTIS/MALDESCENDED TESTIS
When the baby is developing in the womb, the testes normally develop in the loin area just under the kidneys. Differential growth of the body makes the testis move into the scrotum. They should normally be in the scrotum at birth. In some children, the decent of the testis is normally halted at the loin or displaced anywhere along the tract of decent.
In a significant majority of children, the testis is felt in the groin, which can and should be brought down by an operation and fixed to the base of the scrotum, to avoid complications such as injury, torsion, infection, loss of sperm production and rarely cancer changes.
Occasionally the testis is too high to be brought down, because of the small artery. In such situation it is safer to remove such testis.
A child with one testis can have as much normal and fulfilling life as a child with both testes.
WHO SHOULD HAVE THE OPERATION?
- If your child does not have one or both testes in the scrotum
- If you see a swelling in the groin but no testis in the scrotum
- If your child one side of the scrotum is less developed than the other and you do not see the testis Please consult a doctor with special interest in surgery of children
- Your child may need an operation to bring and fix the testis down into the scrotum to avoid possible complications.
ROLE OF HORMONES
Hormones have very little role if any. In less than 20% of cases and those too if the testis can be felt at the neck of the scrotum, there might be a role for hormones.
Generally surgeons do not believe hormone do any good.
WHEN SHOULD THE OPERATION BE DONE?
Majority of the surgeons feel that children with undescended testis should have operative correction before they go to school to avoid embarrassment and teasing from other boys. It also gives nature a chance to rectify the problem. 4 years of age is accepted to be best for operation.
WHAT IS INVOLVED?
- It is a day case procedure done under general anaesthesia
- It usually takes 30 minutes or less
- Child is usually ready to go home in less than 2 hours after the operation
- The sutures are usually dissolving so do not have to be removed.
Some parents notice that in their child who had both testes in the scrotum, one or both suddenly disappears, particularly when the child is being bathed or changed.
This is quite normal and is due a muscle reflex (Cremasteric Reflex) and is a defence mechanism in children.
In Majority no treatment is required, as the testes get into their normal position as child grows. If it is causing concern, they can be fixed to the base of the scrotum by a short operation under general anaesthesia.