Dealing with undescended testicles

Lori Goldwasser was shocked when the hospital’s neonatologist informed her that her newborn son had an undescended testicle.

“I didn’t know what it was and I started to panic,” says Lori.

Dr. Walid Farhat, associate professor at the Department of Surgery at the University of Toronto and a pediatric urologist at SickKids Hospital in Toronto, says that while parents shouldn’t panic, they should take it seriously.

He says, “An undescended testicle occurs when the testicle doesn’t properly descend into the scrotum. Any time that the testicle isn’t in the right position in the sac – if it’s in the groin or abdomen, for instance – the temperature isn’t normal and fertility potential lessens. There is a chance that the baby will be infertile when he grows up – especially if both testicles are undescended.”

In the majority of cases, the testicles descend into the sac within the first six months of a baby’s life, but parents should ensure that their baby’s pediatrician keeps an eye on it and that the baby is referred to a specialist immediately for testing and possible surgery if there is a problem.

“There is evidence that there might be irreversible damage to the testicle within the first year of life if the testicle isn’t brought into proper position. If the surgery is done within a year, there is a chance that we can reverse fertility issues,” says Dr. Farhat.

At the appointment with the specialist, the doctor will feel for the testicles. If surgery is required, the doctor will make a small cut in the baby’s scrotum to bring down the testicle. If the specialist cannot feel the testicle, laporoscopy may be required. This surgical procedure involves making a keyhole incision and using a scope to locate and bring the testicle down into position.

“Fertility is the most important reason to perform surgery,” says Dr. Farhat. “But there is also a small chance that the undescended testicle might develop cancer later on. If the testicle is in the abdomen, the man won’t be able to tell if a tumour has developed. Our hope is that if we bring the testicle into the right position in the scrotum, a man will be able to detect cancer if it develops.”

When Lori’s son was diagnosed, she started to gather some research and consult with her son’s pediatrician. Then she got lucky: the condition resolved itself within a couple of weeks.

“It was such a relief to know that everything was OK,” says Lori, “but it never hurts to be informed and prepared to deal with the unexpected.”

Undescended testicles by the numbers

  • 1% to 3% – The chance that full-term male babies will have an undescended testicle.
  • 30% – The chance that pre-term boys will have an undescended testicle.
  • 70% – The chance that a testicle can be found by a pediatric specialist when not located during an exam at birth.
  • 0.8% – The chance that pre-term and fullterm babies born with an undescended testicle will still have the condition after a year.

Originally published in ParentsCanada magazine, December 2012.

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