DEFINITION
Undescended testes (cryptorchidism / undescended
testikulorum) is an undescended testis into the position it should be, namely
in the scrotum, before the child is born. Kriptorkidisme usually only occurs in
one testicle, but about 10% of cases occur in both testicles.
Most testicle will descend on its own within 6 months after
the child is born. Baby boy born prematurely often have this condition, as well
as baby boys who have a history in the family kriptorkidisme.
CAUSE
The exact cause of testicular descent is not yet known. A
combination of genetic factors, maternal health, and other environmental
factors may cause disturbances in hormones, physical changes and nerve activity
that influence the development of the testes.
Currently fetal development, the testicles are formed in the
stomach. When the last few months of fetal development, the testicles begin to
descend slowly from the abdomen through the inguinal canal in the groin area,
into the scrotum. At kriptorkidisme, the process is stalled or blocked.
SYMPTOMS
Undescended testes do not cause symptoms. The main sign of
testicular descent is not the testicles do not appear or are not palpable in
the scrotum.
Undescended testes can be twisted inside the abdomen
(testicular torsion), so that disrupt sperm production later in the day, and
increase the risk of hernia and testicular cancer.
DIAGNOSIS
Physical examination to make sure that one or both testicles
are inside the scrotum. Undescended testes may be palpated or may not be felt
in the abdominal wall above the scrotum. If the testes are not palpable, it can
be done surgically to support diagnostics and therapy as well. Surgery can be
done by:
·
Laparoscopic. This action uses a small tube with
a camera at one end that is inserted through a small incision in the abdomen of
the child. Laparoscopy is done to determine the position of the testicles in
the abdomen. Laparoscopy also can show whether there testicles or not, or
perhaps only seen a small residual testicular tissue that is not working and
needs to be removed.
·
Open surgery. Exploration operations directly
through the abdomen or groin area through a larger incision may be necessary in
some cases.
TREATMENT
Usually the testicle will descend on its own without
treatment first at the age of 1 year. If the testes do not descend, then the
child may be able to get an injection of the hormone HCG (Human Chorionic
Gonadotropin) to try to make the testes descend into the scrotum.
Surgery (orchidopexy) is usually done to lower the testicles
into the scrotum if the testes do not descend. Surgery is performed early on
can prevent damage to the testicles that can make children become infertile.
If the undescended testis was discovered later, when the
child is large, then it may be advisable to lift it, because the testes will
not function properly and the risk for cancer occur.
REFERENCE
- K, Neil K. undescended testicle. Medline Plus. 2012.
- Mayo Clinic. Undescended testicles (cryptorchidism). 2013.
- P, Elizabeth J. undescended and Retractile Testes. Merck
Manual Handbook. 2012.
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