What is Cryptorchidism and How Common is It?
Cryptorchidism, also known as undescended testicles, is a condition where one or both testicles do not move into the scrotum before birth. This condition affects:
- 3% of full-term male infants.
- 30% of premature male infants.
Typically, testicles descend by the seventh month of gestation. By the time a baby is three months old, 80% of undescended testicles will have moved into the scrotum on their own.
Why is Early Detection of Cryptorchidism Important?
Identifying cryptorchidism early is crucial because untreated cases can lead to serious complications:
- Infertility: Particularly when both testicles are undescended.
- Increased risk of testicular cancer: Risk is higher if not treated early.
- Testicular torsion: Twisting of the testicle, which cuts off blood supply.
- Inguinal hernias: Where part of the intestine protrudes through the abdominal wall.
- Psychological impacts: Issues with body image and self-esteem.
How is Cryptorchidism Diagnosed?
Detecting Undescended Testicles
Doctors can often detect undescended testicles during a physical examination. They use their hands to feel the testicles, usually finding them in the groin area. If the testicles are not felt, they might be located inside the abdomen or may be absent altogether.
Diagnostic Tests
- Ultrasound: Helps locate the testicles, although it is not always accurate.
- MRI: More precise but expensive and often requires sedation.
- Laparoscopy: A small surgical procedure that allows doctors to see inside the abdomen and locate the testicles.
When is Surgery Needed for Cryptorchidism?
If the testicle has not descended by six months, surgery, known as orchiopexy, is usually recommended. This surgery helps move the testicle into the scrotum, reducing the risks of complications and helping to maintain fertility.
Causes and Risk Factors of Cryptorchidism
The exact cause of cryptorchidism is often unknown. However, several factors can increase the risk:
- Genetics: Family history of undescended testicles.
- Maternal health: Conditions like diabetes, obesity, or exposure to certain chemicals during pregnancy.
- Prematurity: Babies born before full term have a higher risk.
What are the Long-term Effects of Cryptorchidism?
Fertility Issues
- Infertility: Seen in up to 30% of men with one undescended testicle and up to 90% with untreated bilateral cases.
Cancer Risks
- Testicular cancer: Men with a history of cryptorchidism have a higher risk, especially if surgery is delayed until after puberty.
Treatment Options for Cryptorchidism
Hormonal Therapy
Hormonal treatments are generally not recommended due to low success rates. They may be used in specific conditions like Prader-Willi syndrome.
Surgical Treatment
Orchiopexy is the preferred treatment and is recommended between 6 and 18 months of age. Early surgery offers better outcomes for fertility and reduces cancer risk.
What Should Parents Know About Cryptorchidism?
Early Diagnosis and Treatment
Regular check-ups with a paediatrician can help detect undescended testicles early. If cryptorchidism is diagnosed, timely surgery can prevent long-term complications.
Post-Surgery Care
After surgery, follow-up appointments ensure proper healing and monitor for any complications. Parents should also be informed about the importance of regular testicular exams as their child grows.
Words of Wisdom from a Consultant Urologist
Early detection and treatment of cryptorchidism are crucial. Parents should ensure their infants have regular check-ups and follow medical advice regarding surgery. With prompt treatment, the risks of infertility and testicular cancer can be significantly reduced, ensuring better health outcomes for the child.
