Also referred to as Cryptorchidism, an Undescended Testis is a condition in which a testis has not descended to its normal position inside the scrotum before birth. It is commonly seen as a birth anomaly in male infants born prematurely. An Undescended Testis may be on one side or on both sides. This condition is generally diagnosed at the time of physical examination of the newborn itself.
The condition should be treated between six months and two years of age; if it does not locate itself correctly by four months of age. Any delay in treatment later than this period lowers the rate of success of the treatment and leads to impaired spermatogenesis. This eventually interferes with fertility later in life and substantially increases the chances of testicular cancer.
The factors which lead to greater chances of Cryptorchidism include premature birth (it is actually the most important factor), low birth weight, a family history of problems related to the development of genitalia, fetus suffering from Down’s Syndrome and other similar conditions, consumption of alcohol during pregnancy, smoking, and exposure to pesticides during pregnancy.
Complications related to Undescended Testis:
For spermatogenesis, the temperature slightly lower than the normal body temperature is required. It is provided by the scrotum located slightly outside the body. An Undescended Testis can lead to a number of complications like testicular cancer, issues related to fertility, torsion of the testis due to a twisted spermatic cord (leading to a reduced supply of blood), and trauma to the testes due to pressure against the pubic bone.
The treatment for an Undescended Testicle is Surgery i.e. Orchidopexy through inguinal exploration if the testis is palpable clinically or Laparoscopy if the testis is not palpable clinically or not visualized on ultrasound. Hormonal treatment by injection HCG has not much role in Undescended testis except in retractile testes.
Take Away Message:
Cryptorchidism or an Undescended Testis is an abnormal location of one or both the testis. If the treatment is delayed or the condition is left untreated, it leads to greater chances of testicular cancer and infertility in males later in life. Treatment is Surgery ie Orchidopexy. Consult a Pediatric Surgeon if a child has absent testis in the scrotum.