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Mrs Kalpana Patil MB BS MS MCh FRCS(Paed)

Consultant Paediatric Urologist

+44 01932 875168

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Undescended Testes

1. What is an undescended testicle?

2. What causes it?

3. How common is it?

4. How is it diagnosed?

5. How is it treated?

6. What are the risks with this operation?

7. What happens after the operation?

 

1. What is an undescended testicle?

At birth majority but not all boys  have 2 testes in the scrotum (skin pouch at the base of the penis) one on each side. This depends on the time of gestation (development) when they are born. If they are born early due to various reasons the testes are still on their way to the scrotum and will get there in a few weeks to months after birth. Commonly it is one testicle that is affected, rarely both may be affected.

In some boys (a small number) despite the fact that they are born at the right time the testes have still not reached the scrotum and could have stopped along the path they follow from the site from where they develop (near the kidneys at the back) to their final destination in the scrotum.
In majority of these boys the testes will eventually reach the scrotum in the first 6 months or so and in the remaining by one year of age.

However if for various reasons the testis has not formed or formed and withered away as it has twisted on itself and cut out its own blood supply obviously the testis will be absent on that side.

As the testes are formed at the back they need to travel from the back to the front through the the groin to finally settle in the srotum.

In some boys the testicle will be in the for  much of the time but cannot be felt there because they naturally rise back into the body through fear or cold temperatures. If so there is no cause for concern. However if the testis is permanently in the abdomen, treatment will be needed.

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2. What causes it?

The normal passage in the groin through which the testicle passes from the tummy to the scrotum is not formed. On rare occasions the testicle does not descend due to other problems with the testicles themselves or with the male hormones.

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3. How common is it?

This condition is more common in premature babies. One in 30 boys born at term may be born with undescended testicle and 1 in 70 the testicle remains undescended.

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4. How is it diagnosed?

Your doctor will need to examine your baby to determine whether the testicles have truly undescended or whether they have slid back into the body temporarily. As a parent you may check on this by feeling for the testicle at the end of a warm bath.

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5. How is it treated?

This is treated with a small operation named ‘orchidopexy’. This involves making a cut in the groin and on the scrotum where the testicle will be anchored, after your baby is anaesthetised. The testis is moved down into the scrotum and the gap is closed. This operation when performed within the first few year of life gives the testicle the best chance to develop normally.

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6. What are the risks with this operation?

A general anaesthetic risk is small but exists. This will be explained by your child’s anaesthetist who is experienced in giving children a general anaesthetic and dealing with any complication should it arise.

As any other opearation the risk of bleeding and infection are there but in small number of boys. Sometimes despite taking care the testicle may be damaged but this will be obvious a few months later at follow up when your boy will be seen by the surgeon in the outpatient department by comparing it with the opposite testis.

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7. What happens after the operation?

Your child may experience some bruising and soreness in the groin around the cuts. You are advised to give him paracetamol every 4 to 6 hourly. Avoid riding a bicycle for a month. There is no need for the stitches to be removed as they are dissolvable.

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