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The cells that form the testicular tissue grow below the kidney as a male baby develops in the womb. As a baby boy grows inside his mother’s womb, his testicles form inside his abdomen and move down (descend) into the testicular sack (scrotum). The testicles develop after the birth, and move down into their proper place in the testicular sack.  However, in some infants, one or both testes will not descend into the sack, and stay in the groin, abdomen, or perianal region, or at the back of the penis. This congenital condition is called “undescended testicles”.

Prof. Dr. Murat Alkan, Pediatric Surgery and Urology Specialist, Medline Adana Hospital says that undescended testicles can lead to psychological and medical problems including infertility, cancer, and can lead to the removal of the testis in older ages, and therefore, must be traded before it is too late as the success of treatment depends on the patient’s age.

It is prevalent

Prof. Dr. Alkan says that undescended testicle in children is a congenital condition with high incidence. “Undescended testis is the condition when one or both testes are not palpable on an adequate examination after birth. One or both of the testes tend to move up into the neck of the scrotum from time to time is called “retractile testes”. A retractile testis is a variation of normal testis, and can descend fully into the scrotum and stay there for a while, but moves freely up into the inguinal canal. Therefore, sometimes it cannot be very easy to differentiate between retractile testes and undescended testes. Patients with impalpable testes should be examined by means of genetics and endocrinology”.

Surgery is necessary, if not moves down

Prof. Dr. Alkan underlines that the prevalence of undescended testes among children under one year of age is nearly one percent, and sometimes a surgical procedure can be necessary, if the testes do not move down into their proper place by the age of six months. “The majority of cases are in male babies born prematurely, or with low birth weight. In newborn babies, the testes are expected to descend fully into the scrotum in four to six months”.

Examination for Diagnosis

Prof. Dr. Alkan points out the importance of the family history, anamnesis, and physical examination in diagnosis “Imaging techniques to locate undescended testicles are not very useful, because they are not accurate enough. Ultrasonography and magnetic resonance can be used. However, they are simply waste of time, and technically not accurate. Moreover, magnetic resonance procedure is performed under anesthesia. This may lead to the administration of another anesthesia for the patients who will most probably need surgical procedures following the imaging. Computerized tomography (CT) is not recommended because of the risks posed by high levels of radiation during a CT scan”.

Time is Crucial

Prof. Dr. Alkan says that babies diagnosed with undescended testes must undergo a surgical procedure as soon as they are six months old, before it is too late, and underlines that the patients are usually discharged from the hospital two or three hours after the surgery, and the recovery period is quite short. “The treatment process should begin when babies are six months old, and the procedure to descend the testicle must be completed before they are 12 months old or 18 months old, the latest. The aim is to increase hormone production, and protect the patient’s fertility, ease parents’ worries, repair the hernia, if necessary, and to reduce the risk of cancer posed by the testes unnoticed in the abdomen, and to move the testes down into their proper place to avoid psychological problems, and to avoid unnecessary imaging procedures”.