Undescended Testicle (Cryptorchidism): Causes, Diagnosis, and Treatment

Undescended testicle, or cryptorchidism, is a common congenital condition in which one or both testicles fail to move into the scrotum before birth. This condition affects approximately 3-5% of full-term male newborns and is more prevalent in premature infants. Early diagnosis and timely intervention are crucial to prevent future complications, including infertility and an increased risk of testicular cancer.

Causes of Undescended Testicle

The exact cause of cryptorchidism is not always known, but several factors may contribute to its occurrence, including:

  1. Hormonal Factors: Insufficient hormonal stimulation during fetal development can impair testicular descent.
  2. Genetic and Familial Factors: A family history of cryptorchidism may increase the likelihood of occurrence.
  3. Premature Birth: Babies born prematurely are at a higher risk since testicular descent usually occurs in the last trimester of pregnancy.
  4. Environmental Influences: Exposure to certain chemicals or toxins during pregnancy may interfere with normal fetal development.

Symptoms of Undescended Testicle

  • Absence of one or both testicles in the scrotum.
  • The affected testicle may be located in the groin or abdomen.
  • In some cases, the testicle may move between the groin and scrotum (retractile testicle), which is a separate condition and usually does not require treatment.

Diagnosis of Cryptorchidism

Diagnosis is typically made during a physical examination by a pediatrician shortly after birth. If the testicle is not palpable, additional imaging studies such as ultrasound or MRI may be needed. In some cases, laparoscopy is performed to locate an intra-abdominal testicle.

Treatment of Undescended Testicle

If the testicle does not descend naturally within the first few months of life, medical intervention is recommended:

  1. Hormonal Therapy: In some cases, hormone injections (hCG or GnRH) may be attempted to stimulate testicular descent, but this is not always effective.
  2. Surgical Treatment (Orchiopexy): Surgery is the primary treatment and is typically performed between 6 and 18 months of age. The procedure involves repositioning the testicle into the scrotum and securing it in place.

Why Is Early Treatment Important?

  • Improved Fertility: An undescended testicle can negatively impact sperm production if left untreated.
  • Reduced Risk of Testicular Cancer: Males with untreated cryptorchidism have a higher risk of developing testicular cancer later in life.
  • Better Testicular Function: Proper positioning in the scrotum helps maintain normal temperature regulation essential for sperm production.
  • Psychological and Aesthetic Benefits: Correcting the condition can prevent future concerns related to body image and self-esteem.

Post-Surgery Care and Follow-Up

After surgery, close monitoring is necessary to ensure proper healing and testicular function. Parents should follow these guidelines:

  • Regular check-ups with the pediatric urologist to assess growth and function.
  • Avoiding strenuous activities for a few weeks post-surgery.
  • Monitoring for any signs of complications such as swelling, infection, or recurrence of undescended testicle.

Conclusion

Undescended testicle is a manageable condition if diagnosed and treated promptly. Early surgical correction significantly improves long-term reproductive health and reduces associated risks. Parents should seek medical advice if they notice any abnormalities to ensure their child rece