Surgery, the only way
Dr. Ramesh Babu Srinivasan explains the problems caused in children who have Undescended Testis.
IN some mammals the testis stays inside the body and comes out only during the breeding season. In human beings, the testis is located outside the body in the scrotal sac. The sperm production is best at temperature two degrees less than the body temperature. This is why the testes are located outside the body.
How it happens
When the baby is formed in the womb, the testis starts developing inside the baby's belly. As the foetus grows, the testes gradually descend and reach the sac. When this does not happen, or is arrested half way, the result is "Undescended Testis". This is seen in 30 per cent of boys born before date (preterm). Among full term boys, the likelihood is one to three per cent.
When the newborn is examined, the paediatrician may suspect the problem when the scrotum is poorly formed. In such cases, one can wait for three to six months for spontaneous descent. After six months, the chances of spontaneous testis descent are low and one should seek medical help.
If the problem is not corrected at the right age, the following problems may occur:
Infertility: When the testis does not descended, it is exposed to higher body temperature, and sperm production is affected. In later life the patients have reduced sperm count and thus have problems in fathering children (50-70 per cent less than normal).
Torsion: When the testis is not descended, it is free to move around. This makes it easy to get twist and cut off its own blood supply. The scrotum gets red and tender within a few hours. If an emergency operation is not done within six hours, the testis is lost.
Testicular Tumour: There is also a small risk of tumour development. If the testis is not brought down, the tumour can develop without being noticed and become advanced before treatment.
For boys with Undescended Testis, surgical correction is recommended within one year (maximum two years). The testis is usually found in the lower part of the belly and fixed to the scrotum after achieving enough length. When the testis is too high inside the belly, a laparoscopic operation is performed to bring it out in two stages with the help of key hole surgery.
Usually the success rate is 95 per cent. When only one testis is affected, and surgery is performed at the right time, there is 80 per cent chance for fertility and paternity. When both testes are affected, there is still 50 per cent chance.
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