This is an automatically translated article.
The article was professionally consulted by Specialist Doctor I Nguyen Thanh Hai - Doctor of Radiology - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International General Hospital.An undescended testicle is defined when the testicles are in abnormal positions instead of inside the scrotum before the baby is born. Common sites of undescended testicles include the abdominal cavity, the inguinal canal, and the shallow and deep inguinal ring. If not detected early, undescended testicles can lead to infertility or testicular cancer in adult men.
1. What is an undescended testicle?
The testicles are an important male organ responsible for the production of sex hormones, testosterone, and sperm production. The normal position of the testicles is in the skin of the two scrotum, next to the penis. The testicles are located next to the external genitalia, have a lower temperature than the body's core temperature, ensuring good conditions for sperm development.During the fetal period, the boy's sperm is located in the abdomen. Over time, sperm gradually move from the abdomen down to the deep inguinal ring, the inguinal canal, the shallow inguinal ring before completely descending into the scrotum at about 8 months of pregnancy. When one or both scrotums are not in the scrotum at birth, the baby boy has an undescended testicle.
Usually, an undescended testicle is only found on the left or right side. Bilateral undescended testicles are uncommon, in less than 10% of cases. According to statistics in the United States, about 5% of full-term newborns have undescended testicles. This number is higher in premature babies, about 20%.
In some cases, the testicles can move back to their normal position within a few months of giving birth. An undescended testicle is defined as an undescended testicle 6 months after birth. Treatment of undescended testicle is mainly based on surgery, bringing the testicle through the inguinal canal into the scrotum. Surgery should be performed early to preserve spermatogenic cells and preserve reproductive function into adulthood. The appropriate time for surgery to treat undescended testicles is on average 3 to 6 months of age. If undescended testis is detected late, surgery should be combined with endocrine support for spermatogenesis. When the testicle is undescended with testicular cancer, surgical removal of the testicle will be an option.
2. Causes of undescended testicles
Mẹ hút thuốc lá khi mang thai là yếu tố nguy cơ gây tinh hoàn ẩn ở trẻ
Decreased activity of the hypothalamic pituitary system: Causes undescended testicles combined with small penis; Decreased synthesis of the sex hormone testosterone ; Abnormal anatomical structures that impede the movement of the testicle into the scrotum, such as fibrosis of the inguinal canal, short scrotal testicular ligament. Undescended testicles appear as a result of a combination of genetic factors and external environmental factors. Some factors increase the risk of undescended testicles in children such as:
Premature babies: In the womb, the testicles undergo a process of development and move from the abdomen to the inguinal canal and down to the scrotum. By about the 8th month of a normal boy's pregnancy, the testicles are completely located in the skin of the scrotum. Therefore, in premature babies, the testicles may not yet reach the scrotum. Monitoring the baby in the first months after birth, the testicles can be palpated in the scrotum; Large fetus: The fetus with a large weight will have a higher risk of having undescended testicles compared to the group of children of normal weight. History of having a relative with abnormalities related to the genitourinary system, especially the external genitalia; A mother who smokes during pregnancy increases the risk of undescended testicles in her baby.
3. What medical techniques help diagnose undescended testicles?
The first sign to suspect an undescended testicle is the size mismatch between the two scrotums. The scrotum on the same side as the undescended testicle is usually smaller in size. If the testicles are hidden on both sides, the size of both scrotums is small and flattened. On physical examination, the physician is usually unable to feel the testicle in the scrotum or detects that the testicle is located in the inguinal canal. If the testicle is in the abdomen, the testicle cannot be detected.Testicular ultrasound is the first imaging method used to diagnose undescended testicles. Testicular ultrasound allows to detect the position of the testicles such as in the abdomen, inguinal canal and examine the structure as well as the feeding vascular system. Currently, there is no evidence of harmful effects of ultrasound on the hormone production and spermatogenesis of the testicles. Therefore, testicular ultrasound is considered a safe, easy, inexpensive, and repeatable technique to diagnose undescended testicles.
When the testicles are difficult to visualize with ultrasound, the doctor may order more valuable imaging techniques such as computed tomography and magnetic resonance imaging of the abdomen. The resulting images are of higher resolution, clearer, and easier to plan for later surgery. In rare cases, laparoscopy is chosen as a diagnostic and therapeutic technique. This is the most accurate technique in diagnosing undescended testicles.
In addition, a number of blood tests to evaluate hormone levels in the patient's body may be ordered in combination, especially when infertility complications appear in adult men. Hormones such as testosterone, estrogen, FSH, and LH are often required to be quantified. In addition, when an undescended testicle is suspected of having testicular cancer, tumor markers are also indicated, including alpha FB, beta hcg.
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