Testicular displacement for inguinal testicles or undescended testicles
Normally, both testicles are in the scrotum at the time of birth. However, in about 3% of boys the testicles stay in the groin area or in the abdominal cavity and do not descend. By the end of the first year of life at the latest, both testicles should be in the scrotum. Whereas in the past hormone therapy using medication was used, nowadays the treatment of choice is surgical relocation of the testicle. In the case of testicles that can be palpated in the groin, direct surgical relocation can be performed. In the case of testicles that cannot be palpated, a laparoscopy is used to locate the testicles in the abdominal cavity.
Questions about the diagnosis and treatment of an inguinal testicle/ undescended testicle
Undescended testicle/ maldescensus testis is a condition in which the testicle is not in the scrotum. In most cases, the testicle is an abdominal organ that develops near the kidneys in an embryo and then migrates into the scrotum until birth. The testicle can get “stuck” along this path or on the side of it. In most cases of undescended testicles, the testicle is already in the groin (inguinal testicle) at birth, shortly before it reaches its destination. Premature birth is the main risk factor for undescended testicles.
A sliding testicle is a subtype of the inguinal testicle in which the testicle can be pulled back into the scrotum by manual traction, but then retracts back into the groin. This must be distinguished from a migratory or pendulous testicle, which is occasionally located in the groin but slips back into the scrotum on its own. In general, this has no clinical significance.
If the testicle is not palpable from the outside, it is known as a hidden testicle, or cryptorchidism.
Treatment should be completed by the age of 1. Therefore, it is necessary to consult a urologist as early as possible, preferably before the child is 6 months old.
Most testicles find their way into the scrotum on their own within 6 months from birth. However, if this does not happen, surgery becomes necessary. Hormone treatments are also available, but these are often unsuccessful and delay the necessary surgical treatment.
Undescended testicles left untreated carry an increased probability of later infertility, as well as a greatly increased risk of degeneration.
A physical examination is supplemented by an ultrasound exam, which can usually determine the location of the testicle. Laboratory tests are necessary, especially in cases of bilateral cryptorchidism. If other malformations are also present, a genetic examination may be necessary.
Short info on inguinal testicle surgery
|Indication||An undescended testicle, if possible within the first year of life|
|Procedure||Mobilisation and “lengthening” of the spermatic cord via groin incision|
|Surgery time||Approx. 1-2 hours|
|Clinic stay||2 days|
|Note||General anaesthesia recommended|
Questions about the surgical procedure for inguinal testicles / undescended testicles
The spermatic cord from which the testicle “hangs” is accessed via an incision in the groin. Blood vessels as well as the vas deferens run through this cord. By detaching the spermatic cord from the surrounding tissue, it can be “lengthened” and the testicle can then be fixed in the desired position through a small incision in the scrotum (orchidopexy).
The procedure is performed under general anaesthesia. A short inpatient stay is recommended after the surgery. We naturally offer the possibility of accommodating the parents in the patient’s room. A check-up should take place after the procedure.
As with any surgery, there are general risks such as bleeding, inflammation, and disruption of wound healing. The procedure also has minor risks of damage to the testicle with subsequent shrinkage and potential recurrence of the protrusion. All possible risks of the surgical intervention are discussed in a detailed consultation before the procedure.
The chances of success of surgical treatment for undescended testicles is good. Early correction increases the chance of retaining fertility and reduces the risk of testicular tumours. However, despite timely surgery, there is a slightly increased risk of a testicular tumour occurring after puberty. Because the testicle can be easily examined through a self-check of the scrotum, a possible testicular tumour can be detected early if the patient is instructed to examine it regularly. Surgical treatment of an inguinal testicle is also advised in older children, as it does help prevent testicular tumours.