CRYPTORCHIDISM OR UNDESENDED TESTES

A Greek word which means ‘hidden testes’ Cryptos – Hidden, Orchis – Testis. It refers a failure of testicular decent into the scrotum. .

It is most common congenital defect, characterized by absence of one or both testes from the scrotum.

  • It is the most common congenital defect of the male genitalia.
  • It may occur bilaterally and unilaterally and may be the cause of infertility if corrective surgery is not done.

 

HOW DOES UNDESCENDED TESTES LOOK LIKE?

 

 ETIOLOGY AND RISK FACTORS

  • Idiopathic ( a combination of genetics, maternal health and other environmental factors may disrupt the hormones and physical changes that influence the development of the testicles.
  • Severely premature infants can be born before decent of testes
  • LBW (low birth weight baby)
  • Diabetes mellitus and obesity of the mother
  • Maternal exposure to estrogen during the first trimester
  • Risk factors also include exposure to regular alcohol intake during pregnancy
  • Cigarette smoking during pregnancy also known risk factor

 

CLINICAL MANIFESTATIONS

 

  • Most patients present in infancy and around school age. A few present after puberty.
  • Absence of one or both testes
  • Swelling in the groin (may be the testis or a hernia)

DIAGNOSTIC EVALUATION

  • MRI scan with a contrast agent: The doctor injects the agent into the bloodstream to give a clearer picture of whether the testicle is in the groin or abdomen.
  • A laparoscopy: The doctor inserts a tiny tube with an attached camera through a small incision in the abdomen. If necessary, they can also perform corrective surgery using the same tool.
  • Open surgery: In rare, complicated cases, surgeons will use this to explore the abdomen directly.

 

MANAGEMENT

 

Treatment is recommended anytime after six months of age. The time between six and 18 months of age is generally considered best, when taking into account surgical and anaesthetic factors.

Surgical therapy include “ Orchiopexy” ( surgically positioning of the testes within the scrotal sac). It is done under general anaesthesia, and the baby almost always go home the same day and usually acts entirely normal within one to two days.

  • An incision about an inch long is made in the groin area. The testicle is separated from all surrounding tissues so that it comes easily into the scrotum where it is stitched into place.
  • After treatment, the testicle usually develops to normal size in the scrotum. However, in some cases the testicle is abnormal to start with and never grows properly.
  • It is recommended that, as a teenager, these patients have regular physical examinations and be reminded to perform monthly testicular self-examination.

COMPLICATION

  • Local pain
  • Skin discoloration
  • Bleeding
  • Infection
  • Trauma to artery
  • Failure rate
  • Hematoma

By – Nursing Tutor – :Ms. Anjali Mall
Department – Dept. of Nursing
UCBMSH Magazine – (YouthRainBow)
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