Parent & Patient Information System 06/09/2015 Page9 / 51 Undescended testis Testis forms and develops in the abdominal cavity and it migrates downwards to the scrotum. In 3% of newborns, testis is not completely located in the scrotum. In most of these children, testis descends to the scrotum within the first 6 months and in a little percent between 6-12 months. The incidence of undescended testis after the first year of life is approximately 1%. Undescended testis describes the situation that testis is not present in the scrotum. However, if the testis sometimes descends into the scrotum and sometimes moves upwards to inguinal region, it is called ‘retractile (shy) testis’ which is different from ‘true undescended testis’. If a testis cannot be palpated in the scrotum, several scenarios are available: testis may be arrested on its way (inguinal canal) during the descent (true undescended), it may be directed to another location (ectopic testis), may be hanged in abdominal cavity (intraabdominal testis), may be affected in development (atrophic) or it may truly be absent due to intrauterine torsion of the vessels of testis (vanishing testis). In majority of the cases, physical examination is adequate to have the diagnosis. In 20% of cases, the testis can not be palpated. The use of the modern imaging tests as ultrasonography, magnetic resonance imaging and computerized tomography unfortnately do not have additional benefit. Therefore, in cases of nonpalpable testis, laparoscopy is used with the aim of both for diagnosis and a treatment. Laparoscopy, is the investigation of testis in the abdominal cavity by placing a telescopic lens through the umbilicus. Undescended testis may cause problems if left untreated. It may cause fertility (fathering a child) problems. The risk of testicular cancer development is higher than the normal population. Early intervention decreases these risks of infertility and cancer development. In most of the patients with undescended testis, a patent (nonclosed) connection between adominal cavity and scrotum (patent processus vaginalis) is present which has a potential to cause hydrocele or hernia. During operation, this opening is also repaired and testis is fixed to scrotum to prevent torsion. The feeling of an empty scrotum additionally may cause anxiety in cosmetic and psychological aspects.
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