Undescended Testes

Undescended testes, or cryptorchidism, is when one or both testicles fail to move into the scrotum before birth.

Overview

Undescended testes, also known as cryptorchidism, is a condition where one or both of a male infant’s testicles fail to move into the scrotum before birth. Normally, the testes descend from the abdomen into the scrotum during the last few months of fetal development. If this process is incomplete, the testicle(s) remain in the groin or abdomen. Undescended testes are common in premature infants and can lead to complications if not treated.

The history of cryptorchidism dates back to ancient times. Early depictions of this condition were noted in ancient Greek and Roman literature. In the 19th century, surgeons began to develop techniques to surgically correct this condition. The first surgical correction of undescended testes was recorded in the late 1800s, and since then, advancements in surgical techniques and a better understanding of the hormonal influences on testes development have contributed to improved treatment outcomes.

Causes

The exact cause of undescended testes is not well understood, but several factors may contribute to the condition:

Prematurity: Infants born prematurely have a higher risk because the testicles may not have had enough time to descend.

Hormonal Factors: Hormonal imbalances during fetal development can interfere with the normal descent of the testicles.

Genetic Factors: Certain genetic conditions or family history of undescended testes can increase the risk.

Maternal Health: Conditions affecting maternal health during pregnancy, such as diabetes, can be a risk factor.

Risk Factors

Several factors increase the likelihood of undescended testes:

  • Premature Birth: Infants born before 37 weeks of gestation are at higher risk.
  • Low Birth Weight: Infants with lower birth weights have an increased risk.
  • Family History: A family history of undescended testes or other genital abnormalities.
  • Fertility Treaments: Undescended testes can occur more frequently when conception was aided by fertility treatments.

Complications

If untreated, undescended testes can lead to several complications:

Infertility: Prolonged absence of the testes in the scrotum can affect sperm production and lead to fertility issues later in life.

Testicular Cancer: Increased risk of developing testicular cancer in undescended testicles.

Hernia: Increased risk of inguinal hernia in the groin.

Testicular Torsion: Risk of the testicle twisting on itself, cutting off its blood supply and causing severe pain.

Prevention

There is no sure way to prevent undescended testes, but certain measures during pregnancy may help mitigate risk:

  • Prenatal Care: Regular prenatal visits to monitor the health of the mother and developing baby.
  • Healthy Lifestyle: Maintaining a healthy diet and avoiding smoking and alcohol during pregnancy.
  • Managing Maternal Health Conditions: Proper management of conditions such as diabetes.

Symptoms

  • Absence of one or both testicles from the scrotum
  • A palpable mass in the groin
  • Asymmetrical or undeveloped scrotum
  • Discomfort or pain in the groin or abdomen

When to see a doctor

  • Absence of one or both testicles in the scrotum beyond six months of age
  • Inguinal hernia
  • Difficulty palpating the testicle
  • Persistent pain or discomfort in the groin area
  • Symptoms of testicular torsion, including sudden, severe pain, swelling, and redness

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