What is cryptorchidism and how does it affect testes in children?
Cryptorchidism is a condition where one or both of the testes do not descend into the scrotum before birth. It is also known as undescended testes or UDT. It is the most common congenital abnormality of the male genitalia, affecting about 3% of full-term and 30% of premature male infants. The testes normally descend from the abdomen into the scrotum during the last two months of pregnancy. If this process is interrupted or delayed, the testes may remain in the abdomen or in the inguinal canal (the passage through which the testes descend). Cryptorchidism can affect one or both sides, but it is more common on the right side.
What are the causes and risk factors of cryptorchidism?
The exact causes of cryptorchidism are not fully understood, but they may involve genetic, hormonal, environmental and anatomical factors. Some possible risk factors include:
- Premature birth or low birth weight
- Family history of cryptorchidism or other genital abnormalities
- Maternal exposure to certain medications, chemicals or substances during pregnancy
- Maternal smoking, alcohol consumption or diabetes during pregnancy
- Chromosomal or genetic disorders, such as Klinefelter syndrome, Down syndrome or Prader-Willi syndrome
What are the complications and consequences of cryptorchidism?
Cryptorchidism can have several negative effects on the health and development of the affected child, such as:
- Increased risk of testicular cancer, especially if the testes remain undescended after puberty. The risk is higher for bilateral cryptorchidism (both sides affected) and intra-abdominal testes (testes located inside the abdomen).
- Reduced fertility and sperm quality, due to abnormal temperature regulation and hormonal imbalance in the undescended testes. The sperm production may be impaired or absent in some cases.
- Psychological and emotional distress, due to cosmetic and social concerns about having an abnormal appearance of the scrotum and penis. The child may feel embarrassed, ashamed or insecure about his condition, especially during adolescence.
- Increased risk of testicular torsion, hernia, infection or trauma, due to the abnormal position and mobility of the undescended testes. These conditions may cause severe pain, swelling and damage to the testicular tissue.
How is cryptorchidism diagnosed and treated?
Cryptorchidism is usually diagnosed by a physical examination of the child's genitalia by a pediatrician or a urologist. Sometimes, imaging tests such as ultrasound or diagnostic laparoscopy may be used to locate the position and size of the undescended testes. Blood tests may also be done to check the levels of hormones.
The main treatment for cryptorchidism is surgery, called orchidopexy or orchiopexy, which involves moving the undescended testes into the scrotum and fixing them in place. The surgery is usually performed between 6 and 18 months of age, but it can be done later if necessary. The surgery has a high success rate and can prevent most of the complications and consequences of cryptoorchidism. However, some children may still have reduced fertility even after surgery.
In some cases, hormone therapy may be used to stimulate the descent of the testes before surgery. This involves injecting human chorionic gonadotropin (hCG) or luteinizing hormone-releasing hormone (LHRH) into the child's body. However, hormone therapy is not very effective and has some undesirable side effects.
What are some tips for parents and caregivers of children with cryptorchidism?
If you have a child with cryptorchidism, here are some things you can do to help him cope with his condition:
- Seek medical advice as soon as possible and follow the recommended treatment plan.
- Schedule regular check-ups with his doctor to monitor his condition and screen for any complications.
- Support your child emotionally and reassure him that he is not alone or different from other boys.
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