Treatment for both-sided undescended testes in children

A common urogenital condition that boys can have at birth is undescended testes. Reported in 1-3% of full-term male infants, and 15-30% of premature infants, undescended testes is a condition where the boy’s testes, which make and store sperms, are not present in their usual location, the scrotum.

Why are testes undescended?

In the usual scenario, the testesthat are formed in the abdomen descend into the scrotum shortly before birth. Due to uncertain reasons, the testes may fail to descend and stay up in the abdomen or the groin region. Though there is no clear reason behind it, undescended testes are more common in babies born prematurely.

Unilateral and Bilateral undescended testes

Normally, two testes are present in boys. A unilateral undescended testis is when one of the testes is undescended, however, in bilateral both testes are undescended. Both conditions warrant treatment.

Treatment for Both-Sided Undescended Testes in Children (Orchiopexy)

Why is it important to treat undescended testes?

The Scrotum, which is the usual location of testes has a slightly lower temperature than the rest of the body. This low temperature is essential for the adequate functioning of the testes and for sperm production. In case the testes remain in the abdomen, they do not function well and could cause infertility. Apart from this, undescended testes also increase the chances of inguinal hernia and testicular cancer in the affected boys. In some cases, the undescended testis may not be formed well. In such a cases too, removal of the testis is important because testicular remnants are also prone to similar complications.

How will I know if my child has undescended testes?

Undescended testes are diagnosed during the physical examination at birth. Your doctor will inform you in case this condition exists.

Retractile testis unlike undescended testes, moves up and down in the scrotum due to a strong muscle reflex or cold weather conditions. It comes down into its normal position at the bottom of the scrotum on its own. Most children outgrow this condition automatically and do not need any treatment for it.

When will my child be treated for undescended testes?

Babies diagnosed with this condition at birth are followed up with a pediatrician. In some cases, the testes may descend in days to months after birth. However, if they do not descend by themselves till six months of age then the child will require surgery for it.

It is advised that children with undescended testes be treated within two years of life.

What is the treatment for undescended testes?

The recommended treatment for correction of undescended testes is Orchiopexy. This is a surgical treatment to locate and bringthetestesinto the scrotum.

Is it safe for babies to undergo a surgical procedure?

Yes, pediatric surgery and urology have transformed completely today. With the advent of minimally invasive laparoscopic procedures children can safely undergo urogenital surgical procedures including treatment for undescended testes. Conventional surgical procedures when needed are also done with utmost care and are equally safe.

 The procedure is done by a pediatric urologist and surgeon who is highly skilled in performing surgical procedures on babies.

What is done during Orchiopexy? 

Orchiopexy is performed under anesthesia and requires two cuts, to locate and bring the testes down. Many a time the testes cannot be located in the abdomen even with an ultrasound or highly-sensitive MRI. It is with a meticulously performed laparoscopy that the pediatric surgeon can definitively locate the testes in such cases. If the testes found are healthy with good blood supply that can be brought till the scrotum without tension, then they may be brought down during the same surgery. In case the testes are located far above in the abdomen or they are unable to be reach the scrotum without compromising blood supply then two separate surgeries are required at six-month interval. Two staged surgeries improve chances of viability of testis and prevent retraction.

Treatment for Both-Sided Undescended Testes in Children (Orchiopexy)

Does Orchiopexy require hospitalisation?

Conventional orchiopexy is a day-care procedure and may not require overnight hospitalisation. Minimally invasive laparoscopic proceduresensure faster recoveryand minimal discomfort.

What is the after-care for Orchiopexy?

Most children over 12 months of age can resume normal activities about two or three days after an orchiopexy. However, any activities that strain or injure their abdominal or groin region should be avoided. Examples include straddling, riding a tricycle, sitting on a see-saw, and swinging.

The affected areas for the child should be kept as clean as possible to prevent infection. Parents are advised to wash their hands with soap and water before handling the child’s bandages and incision areas. For a week, sponge bath or light shower should preferred.

Orchiopexy has a high success rate and most children go on to have healthy testes with normal sperm production later in life.