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Undescended Testicles/Cryptorchidism

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  3. Undescended Testicles/Cryptorchidism

Overview of Undescended Testicles/Cryptorchidism

Undescended Testicles Meaning in Urdu

اس بیماری کی وجہ سے پیدائش سے قبل لڑکوں میں ایک ٹیسٹیکل تھیلی میں وہاں موجود نہیں ہوتا جہاں اسے موجود ہونا چاہیے۔ عام طور پر صرف ایک ٹیسٹیکل ہی اپنی جگہ پر موجود نہیں ہوتا، تاہم دس فیصد تک اس بات کے امکانات دونوں ٹیسٹیکلز اپنی جگہ پر موجود نہ ہوں۔ جب ماں کے پیٹ میں بچے کا جسم بن رہا ہوتا ہے تو اس پراسس کے دوران ایک یا دونوں ٹیسٹیکلز اپنی جگہ پر نہیں پہنچ پاتے۔ اگر بچے کی پیدائش کے چار ماہ بعد بھی ٹیسٹیکل اپنی اصل جگہ پر نہ آئے تو پھر اس کو اپنی جگہ پر لانے کے لیے عمومی طور پر سرجری کی ضرورت ہوتی ہے۔

Undescended testicles, also known as cryptorchidism, is a condition in which one or both testicles fail to move into the scrotum before birth. During fetal development, the testicles are formed in the abdomen and then gradually move down into the scrotum through a passageway called the inguinal canal. In some cases, one or both testicles may not descend fully or at all, remaining in the abdomen or somewhere along the inguinal canal.

Prevalence of Undescended Testicles

Undescended testicles are common in premature infants, affecting up to 30% of premature male newborns. However, most cases resolve spontaneously within the first few months of life, and only about 1% of full-term infants have persistent undescended testicles.

Signs and Symptoms of Undescended Testicles/Cryptorchidism

In most cases, undescended testicles do not cause any symptoms. However, in some cases, the undescended testicle may cause discomfort, pain, or swelling in the groin area. In infants, the scrotum may appear underdeveloped or smaller than expected.

Types of Undescended Testicles/Cryptorchidism

There are two types of undescended testicles:

  1. Palpable Undescended Testicle: It occurs when the testicle can be felt in the groin but has not descended into the scrotum. The testicle may be located anywhere along the path it should have taken during fetal development.
  2. Non-palpable Undescended Testicle: It occurs when the testicle cannot be felt in the groin or scrotum. The testicle may be absent, located deep in the inguinal canal or abdomen, or it may have never formed.

It's important to differentiate between these two types, as they require different treatment approaches. Palpable undescended testicles are typically treated with surgery, whereas non-palpable undescended testicles may require further diagnostic tests, such as ultrasound or MRI, to determine the location and feasibility of surgery.

Causes of Undescended Testicles/Cryptorchidism

The exact cause of undescended testicles is not always clear, but several factors may contribute to the condition. These include:

  • Hormonal imbalances: The testicles require a specific balance of hormones to descend properly. If this balance is disrupted during fetal development, the testicles may not descend fully.
  • Abnormalities in the development of the testicles: Genetic mutations or abnormalities in the formation of the testicles can also lead to undescended testicles.
  • Premature birth: Infants who are born prematurely are more likely to have undescended testicles because the testicles may not have had enough time to descend fully before birth.
  • Other medical conditions: Certain medical conditions, such as Down syndrome or spina bifida, may increase the risk of undescended testicles.
  • Environmental factors: Exposure to certain chemicals or toxins during pregnancy may increase the risk of undescended testicles.

It's important to note that in most cases, there is no known cause of undescended testicles.

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Risk Factors of Undescended Testicles/Cryptorchidism

Undescended testicles can cause long-term complications if left untreated, such as:

  • Infertility: Men with untreated undescended testicles are at a higher risk of infertility due to the warmer temperature inside the body, which can affect sperm production.
  • Testicular cancer: Men with untreated undescended testicles are also at a higher risk of developing testicular cancer later in life.

Therefore, it is important to seek medical attention if you suspect that you or your child may have undescended testicles. Early diagnosis and treatment can prevent long-term complications.

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Prevention

It is not always possible to prevent undescended testicles, as the exact cause is not always known. However, some steps can be taken to reduce the risk of the condition:

  • Avoiding exposure to harmful substances during pregnancy: Pregnant women should avoid exposure to harmful chemicals and toxins that may affect fetal development.
  • Treating hormonal imbalances: If there is a known hormonal imbalance that can cause undescended testicles, it may be possible to treat it during pregnancy or shortly after birth.
  • Avoiding premature birth: Pregnant women can take steps to reduce the risk of premature birth, such as maintaining a healthy lifestyle and seeking prenatal care.
  • Genetic counseling: Couples with a family history of undescended testicles may benefit from genetic counseling to assess their risk of passing the condition on to their children.

It's important to note that in many cases, undescended testicles cannot be prevented, and early diagnosis and treatment are key to preventing long-term complications.

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Diagnosis

Undescended testicles are typically diagnosed during a physical exam by a doctor, often in the first few months of life. The pediatrician will look for the presence of testicles in the scrotum and check for any abnormalities or signs of swelling or discomfort in the groin area.

If the testicles are not in the scrotum, additional testing may be needed to determine their location. This may involve:

  • Imaging tests: Ultrasound, MRI, or CT scans may be used to visualize the location of the testicles.
  • Hormone tests: Blood tests may be used to check hormone levels that affect testicular descent.
  • Laparoscopy: In some cases, a minimally invasive surgical procedure called laparoscopy may be used to visualize the testicles and determine their location.

If a non-palpable undescended testicle is suspected, further testing may be necessary to determine the feasibility of surgery to bring the testicle down into the scrotum.

Treatment of Undescended Testicles/Cryptorchidism | When to Consult a Doctor

The treatment for undescended testicles depends on several factors, including the age of the patient, the location of the undescended testicle, and the presence of any other medical conditions. In general, treatment options include:

  • Observation: In some cases, a doctor may choose to monitor the undescended testicle for some time to see if it descends on its own.
  • Hormone therapy: Hormone therapy may be used to stimulate testicular descent in infants under six months old. However, this treatment is not always effective and is not commonly used.
  • Surgery: Surgery is the most common treatment for undescended testicles. The surgery goal is to bring the testicle down into the scrotum and secure it in place. This is usually done through a small incision in the groin or scrotum. Surgery is typically recommended before the age of 1 to minimize the risk of long-term complications such as infertility or testicular cancer.

If the undescended testicle is non-palpable, more extensive surgery may locate and bring down the testicle. In some cases, it may not be possible to bring the testicle down into the scrotum, and it may need to be removed.

It's important to follow up with a renowned pediatrician after treatment to ensure that the testicle remains in the scrotum and to monitor for any long-term complications.

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