Mom's Must Know: Testicular Abnormalities Are Not Located in the Genital Sac or Undescended Testicles (UDT) This is a disorder that is quite often found in the field of pediatric surgery.

 

Please know, Friends of Hermina, that testicular abnormalities are not in the genital sac. Undescended testicles are an abnormality that is quite often found in the field of pediatric surgery.

Undescended testicles are the most common genital problems encountered in children. Literally, undescended testicles mean testicles or testicles that do not descend to the scrotum. Testicles is the Latin name for the seeds or testicles, which are male reproductive organs that can produce sperm and male hormones, while scrotum is the medical term for the scrotum where the testicles should be located. This disorder often occurs in male babies, namely in 4-5% of male babies at term and 20–33% of premature male babies.

Undescended testicles are the most common genital problems encountered in children. Literally, undescended testicles mean testicles or testicles that do not descend to the scrotum. Testicles is the Latin name for the seeds or testicles, which are male reproductive organs that can produce sperm and male hormones, while scrotum is the medical term for the scrotum where the testicles should be located. This disorder often occurs in male babies, namely in 4-5% of male babies at term and 20–33% of premature male babies.

The cause of undescended testicles in babies has not been known for certain until now. Some things that are thought to have an influence include:

• Genetic factors (heredity)
• Health conditions during pregnancy
• Hormonal disorders
• Physical and neurological disorders

Undescended testicles can be divided into palpable or palpable (80%) and nonpalpable or not palpable (20%). The diagnosis of undescended testicles can be determined through a physical examination carried out by a doctor. However, if the testicles are not palpable, further examinations such as abdominal ultrasound or laparoscopy can help to detect and even lower testicles that are located high up, even testicles that are still in the abdominal cavity.

The treatment carried out is an operation with a medical term called orchidopexy to lower and tie the testicles into the scrotum. This aims to allow proper growth and development of the testicles because the testicles need to be at a temperature of 3–4 degrees Celsius below the body temperature provided by the scrotum. If development is good, sperm formation in the future will not be disturbed. However, if testicular growth occurs outside the scrotum, the testicles get more heat than they should, increasing the risk of testicular damage such as infertility and turning into malignant tumors or testicular cancer in the future. Apart from that, it can also cause fertility problems and twisting of the testicles, also known as testicular torsion, which is characterized by swelling and acute pain and even carries the risk of testicular loss or death.

The optimal time to perform orchidopexy is when the child is 6–12 months old. The surgical process aims to place and tie the testicles to the scrotum with two small incisions in the inguinal and scrotum, or if the testicles are in the abdomen, the method used is laparoscopy to assist the testicular descent operation. Post-operative wound healing from the orchidopexy procedure is very fast, and after 1-2 days, the patient can return to full activities. Exercise may need to be avoided for 1-2 weeks.

Hormonal therapy to treat undescended testicles is still controversial and is not recommended by the American Urological Association. According to the most reliable research currently available, the testicles will not descend spontaneously or with hormone therapy after the age of 6 months.

When the child is 14 years old, examinations for puberty and the possibility of infertility and malignancy also need to be carried out. Infertility may occur in 1 to 3 out of 4 adult men, and the risk of malignancy is 5–10 times higher in men with a history of UDT.

If your little one experiences undescended testicles, immediately have your little one's health checked by a specialist pediatric surgeon to get the right treatment so as not to cause complications in the future.

 

Made by: Dr. . Raissadita Novdyla

Reviewed by: Dr. . Dikki Drajat Kusmayadi, Sp.BA., Subsp. D.A.K.

Reference:

[Guideline] Kolon TF, Herndon CD, Baker LA, Baskin LS, Baxter CG, Cheng EY, et al. Evaluation and treatment of cryptorchidism: AUA guideline. J Urol. 2014 Aug. 192 (2):337-45. [QxMD MEDLINE Link]. [Full Text].

Fantasia J, Aidlen J, Lathrop W, Ellsworth P. Undescended Testes: A Clinical and Surgical Review. Urol Nurs. 2015 May-Jun. 35 (3):117-26. [QxMD MEDLINE Link].

Hutson JM. Orchidopexy. Dalam: Puri P, Höllwarth M, penyunting. Pediatric Surgery. Jerman: Springer, 2006; hal 555-576.

Hutson J. Cryptorchidism. Dalam: Puri P, Höllwarth M, penyunting. Pediatric Surgery: Diagnosis and Management. Jerman: Springer, 2009; hal 919-926.

Kusmayadi, dr. Dikki Drajat. 2020 Maret. Buah Zakar/Testis Tidak Turun (Undescensus Testis/UDT). Youtube. https://youtu.be/7dHBrpfyLSQ?si=pbf02ar6Ct_WeEn1