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Forum Name: Male Sexual Disorders
Question: Undescended Testicle
|S. HUSSAIN - Fri Jan 16, 2004 12:32 pm||
Good day. First we would like to introduce our deep thanks to you for this service. Our case is for our kid and it could be summarized as follows:-
Our son is of 13 years. Upon his birth in 1991, he has got a right scrotal hernia with undescended testicle. 50 days after his birth we have done the hernia operation for him. The surgeon also lays and extend the testicle to it extreme location but it is still in the inguinal canal and not in the scrotum.
When he was of 3 years old, the urinary tracts surgeon explore his situation and said that the undescended testicle was small in size and his opinion is that the boy did not need further surgery.
When he was of 12 years, the surgeon touch the right testicle in the canal and said that it was moved a little in the direction toward the scrotum but it is still out side it in the canal. The sonar U/S report shows that:
- Left test : normal size ( 14/20/9 mm ), seen in situe.
- Right test : small size ( 7/5/6 mm ), seen in the scrotum but highly up not in siute.
Both show no fluid collection.
CONCLUTION : small right test. not in situe.
The surgeon advice us to continuo explore his situation periodically.
Now, he was of 13 years old, we took for him the sonar U/S report which shows that:
- Right testicle: mal descent “ post operative after birth” is seen in the inguinal canal and measured 19 x 7 mm in diameter.
- Left testicle: Normal size and echogenicity and measured
10 x 26 mm in diameter.
The important note best to our knowledge, that the size of the right testicle grows to a considerable measure, and it advanced in the canal toward the scrotum but it is still out side it. The opinion of the surgeon now is to do a surgery operation to download the testicle to the scrotum and he expects that may be it will functionally work like left normal testicle.
We need to know your kind opinion in addition we have some questions as well. Our questions are:
- Is the surgery operation now useful to make the testicle of (19 x 7) mm to work normally in the future?
- Is the surgery consists of one operation only, or it may need more than one operation?
- Other opinion says that it make no difference if you leave it as it with out need to surgery as it is of small size?
Please, it too kind of you and highly appreciated if you could help us and advise us in this subject with our kind regards.
|Dr. Russell M - Thu Jan 22, 2004 10:40 am||
Cryptorchidism [undescended testis] is what we are dealing with here. I find that you have already had your briefings with the urologist, and as such, your queries are on controversial areas in urology.
"Is the surgery operation now useful to make the testicle of (19 x 7) mm to work normally in the future?"
I doubt if you will find straightforward answers to your questions. Nevertheless, I do know that as your urologist suggested, it would be possible that the smaller testicle may function better with another surgery.
"Is the surgery consists of one operation only, or it may need more than one operation?"
As to how many more surgeries would be required, it might depend on the state of the testicle presently and the outcome of the efforts to anchor it.
"Other opinion says that it make no difference if you leave it as it with out need to surgery as it is of small size?"
Infertility and malignancy are two risks of cryptorchidism. Only about 10% of men with history of unilateral cryptorchidism develop infertility, a rate which is similar to that found in other studies in the general population. From this statistics, it can be concluded that leaving the maldescended testis alone would make little difference in terms of infertility.
Surgery is not protective against the development of future malignancy. Periodic exploration, as your doctor suggested, and biopsy of the undescended testis is recommended for early detection and management of cancer. Again, we find that it makes not much difference if we decide to operate knowing well that it will not prevent this risk.
I see that you are facing difficult questions here. The need of the hour is hope and trust in the origin of us all. Whatever we decide upon, we have the best intentions at heart, and whatever the outcome, let us pray for strength to face any consequence of our better intentions.
Praying for the best to come out of the future of your son,
With warm regards,
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