Both testicles are located under the abdomen and behind the penis in a leather bag called the scrotum in adults. When in the womb, they are just below the kidneys, that is, in the abdomen. In the 7th month before birth, they depart from this region, pass through the inguinal canal and descend into the bags close to birth. Undescended testis It occurs as a result of not taking this journey. It is seen in about 3 out of 100 babies born at term. It is seen in 33% of preterm babies (premature babies). As premature babies start to gain weight over time, the testicles begin to descend. Spontaneous descent may also occur in term infants in the first few weeks or months, so approximately 0.8-1% of 1-year-old infants may still have undescended testicles.
Although many ideas have been put forward about its causes, its mechanism of formation has not been fully understood yet. However, the risk of infertility and testicular cancer in children with undescended testicles is higher than in the normal population, therefore treatment and follow-up are absolutely necessary.
The true undescended testis does not descend after the 6th month, and changes in the testis begin after this period and sperm producing cells are damaged over time.
Some families state that they have observed that their child’s testicles run into the inguinal canal from time to time, but settle into the scrotum when gently pushed from the top down. These observations of the mothers are real and this situation is called mobile (retractile) testis. Retractile testicles are common in children aged 5-6 years. These cases are often (and not given sufficient care) confused with a true undescended testis. Retractile testes, which are usually bilateral, completely settle into the sac (scrotum) in early adolescence without the need for treatment. Since the retractile testicles are in the bag most of the time, sperm production is not affected.
Families should check from birth whether their babies’ testicles are in place. If one or both testicles are missing or if the family has any doubts about this, they should definitely take the baby to a doctor, preferably a pediatric urologist. Babies with undescended testicles must be examined before the age of 1 year. Thus, it is ensured that physicians investigate whether there is another problem with the undescended testis in the early period, especially if there is a problem that causes suspicion in the sex of the baby.
There are two options for its treatment: drug therapy and surgical treatment. The aim of surgical treatment is to bring the testis to its normal position in the bag in one or sometimes two sessions. In order for the testicles to continue their normal development, they must be in their normal positions. If they are not included here, first of all, their development is impaired and they become smaller and smaller.
Since 2001, we have been performing the surgical treatment of the undescended testis with a different technique with a small incision in the ovarian sac (scrotum). We have the largest number of patients in the world with this surgical technique called Scrotal Orchiopexy. The inguinal incision made in the classical treatment is not made in this surgery. Thus, children stand up earlier and less complications are observed. One of the important advantages of this surgical technique is that there is no surgical scar. We also have various studies on this subject published in important journals around the world.
After the dressing to be made for 5 days after the operation, daily normal life is returned.
