Undescended testicle

Cryptorchidism, also known as undescended testicles, occurs when the testicle is not in its usual position. This condition can occur in one or both testicles and is a prevalent genital anomaly among young boys.

As soon as this irregularity is identified, swift action must be taken to safeguard the child from potential infertility or the development of cancer later in life.

When a child is experiencing an undescended testicle, it is important not to confuse it with an oscillating testicle, also referred to as testicle elevator. This intriguing phenomenon involves the testicle moving back and forth between its normal location within the bursa and an unusual location between the abdomen and scrotum. The pediatrician is the expert in this situation, as they can determine if it is a true case of cryptorchidism or simply an oscillating testicle.

During the development of the testicles in the womb, a common issue can arise known as undescended testicles. This occurs when the testicles, which typically form in the abdomen, fail to descend into the bursa as the pregnancy progresses. While this natural process should occur towards the end of the pregnancy, there are instances where a complication arises and the testicle does not make its way to the correct location, remaining in the abdomen or inguinal canal instead.

During the initial appointment, the pediatrician will use palpation to diagnose the condition. This quick and straightforward examination allows the pediatrician to determine if the testicle is not in its usual place (or if both testicles are missing). Additional exams will be needed to confirm if it is truly cryptorchidism or a mobile testicle. The pediatrician will also assess for other potential issues that may be connected to this, such as an inguinal hernia.

If the pediatrician is unable to detect the testicles in the bursa or inguinal canal, it is possible that they are located in the abdomen where they cannot be felt. In such cases, the pediatrician may order further tests, such as an ultrasound, to aid in accurately diagnosing the condition.

The optimal solution for treating undescended testicles and repositioning them is through surgical intervention. It is recommended that this procedure be carried out before the age of 2 for maximum efficacy.

The success of this surgery hinges heavily on the specific location of the testicle:

When feeling for the testicle in the inguinal canal: the surgeon will make an incision in the groin area and then gently guide the testicle into the bursa. If the child has a hernia, it can be addressed with a surgical procedure performed at the same time.

« If the testicle cannot be felt, a laparoscopic exploration of the abdomen is conducted. The surgeon makes a small incision in the abdomen, providing access for a mini-camera to be inserted and give a clear view of the abdominal cavity. This allows for the detection of the testicle within the abdomen.

When considering potential complications, infections, scarring issues, and hematoma are all possible concerns that should be thoroughly addressed with the surgeon prior to undergoing the procedure. It is crucial to discuss the potential side effects and risks in order to ensure a successful and safe operation. It is advisable for the child who has undergone the procedure to refrain from engaging in physical activities, such as cycling, swimming, or contact sports for a few weeks after leaving the clinic. This precaution is necessary to minimize the risk of complications and allow the child’s body to properly heal.