An undescended testicle is one of the causes of infertility. This means that one or both of the testicles are hidden due to failure to move into the scrotum before birth.
The exact cause for an undescended testicle isn’t known. Undescended testicle is fairly common in premature Infants, who are delivered early, while it is relatively uncommon in full term ones. About 3 to 4% of full term infants have undescended testicles.
A combination of factors including family history, hormonal disorders, abnormal birth weight and low intra-abdominal pressure of the embryo may affect the testicular development and cause this failure.
Undescended testicle has no symptoms, except that there is an empty scrotum. The testicles can’t be found in the scrotum. After puberty, adult males with undescended testicles suffer from many problems with infertility and sometimes, they suffer psychologically.
Undescended testicles are diagnosed through physical examination only. During this examination, the doctor won’t feel any testicles in the scrotum. However, they may be felt on the abdomen above the scrotum.
Undescended testicles, if untreated, may lead to atrophy of the testicles that causes permanent infertility of the affected adult males. Also, it increases the risk for testicular cancer. It makes the diagnosis of this type of cancer very difficult. And, this worsens the problem greatly.
It may be accompanied with other abnormalities such as hernias and testicular injury, especially when it is present near the pubic bone. In adult males, the concerns regarding body image may cause many psychological problems.
The aim of the treatment of the undescended testicles is to bring them into their normal position in the scrotom. There are two options available, surgery and hormonal therapy.
Usually, undescended testicle is corrected by surgery. It is recommended at the third to the sixth month of life and before the fifteenth month to reduce the complications that may result from undescended testicles, such as hernia and testicular cancer.
During the surgery, the surgeon carefully manipulates the testicle into the scrotum and stitches it into place. This is done through relatively small incisions and may be done through a laparoscopic device. In some cases, the surgeon may find that the testicle is poorly developed, abnormal or a dead tissue. The surgeon will then remove this testicular tissue.
The doctor may recommend checking this surgically-descended testicle regularly through physical examination, Ultrasound imaging of the scrotum or by testing the hormonal levels.
This involves an injection of human chorionic gonadotropic (HCG). This hormone may cause the testicle to move into the scrotum. Hormonal therapy is less effective than surgery. And, it may contribute to premature puberty, known as precocious puberty.
In cases where the testicle was damaged and removed, other treatments are indicated to reduce the physiological and psychological consequences that may occur. They include hormonal replacement therapy to achieve normal puberty and physical maturity. In addition, a saline filled testicular implant for the scrotum may give the appearance of two testicles in the scrotum to prevent any psychological problems.