CO was born at the expected date like every normal child. He weighed 3.4 kilograms at birth and cried well to the satisfaction of his mother. While giving him his first bath, the nurse noticed that one of the testes was not felt in his scrotum. CO had Undescended Testis.
Undescended or mal–descended testis refers to the failure of the testis to reach the bottom of the scrotum. It occurs in three out of hundred male children born at maturity (after at least 37weeks of pregnancy). The risk of undescended testis is higher in male children born prematurely (before 37 weeks of pregnancy).
Normal development of the testis: The testis develops within the abdomen while the baby is still unborn. With the aid of several hormones, which include testosterone, the processes of descent of the testis and the surrounding tissues from the abdomen into the scrotum begins. This starts by twenty three weeks of pregnancy. The descent is usually completed before thirty four weeks of pregnancy.
Possible locations of the undescended testis/testes: The abnormally located testis may be in the abdomen, the groin, the other scrotum, or root of penis ( junction of penis to the abdomen).
Effects of undescended testes: Failure of the testes to descend into the scrotum is associated with some problems such as
- Testicular torsion- a painful condition in which the spermatic cord attached to the testis twists on itself.
- Cancer of the testis
- Inguinal hernia: Hernia in the groin region.
- Injury: Due to the location of the undescended testis or testes in the lower abdomen, possibility of injury is high.
Management of undescended testis: In many children, the testis will descend on its own before the child’s first year birthday, however, majority will have occurred by six months of age.
Among children whose testis/testes have not descended by their sixth month of age, treatment is usually advocated between six and eighteen months of age. Options of treatment include
- Hormonal treatment: This has been tried in the past but it is not widely recommended.
- Orchidopexy: This surgical treatment will position and fix the testis in the scrotum. Any hernia present is also repaired.
In conclusion, undescended testis is one of the common problems in newborn. Early diagnosis and treatment can result in satisfactory outcomes.
Key Recommendation: Every new born male child should be examined for presence of the two testes. In case of any doubt, a doctor should be consulted immediately.
Dr Benjamin Odusanya is a Consultant Urologist. He is a Fellow of The West African College of Surgeons (FWACS) and The Medical College of Surgeons (FMCS). He works at The General Hospital, Marina, Lagos. He can be contacted on firstname.lastname@example.org.