Our Summary

Cerebral palsy is a rare condition that occurs after an injury to the brain while it’s still developing. It can cause various issues, including muscle tightness, intellectual impairment, and more. Boys with cerebral palsy often have a high incidence of undescended testicles. The reasons for treating this (such as preventing infertility and cancer, dealing with psychological aspects, and avoiding testicular torsion) are the same as those for boys without neurological impairment. However, deciding whether to treat undescended testicles in boys with cerebral palsy is more difficult. This decision involves not just medical and surgical considerations, but also complex ethical issues.

FAQs

  1. Why is the incidence of undescended testis high in boys with cerebral palsy?
  2. What are the reasons for treating undescended testis in boys with cerebral palsy?
  3. What ethical issues arise in the decision-making process for undescended testis surgery in boys with cerebral palsy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about undescended testicle surgery is to make sure to follow post-operative care instructions carefully to ensure proper healing and reduce the risk of complications. This may include keeping the surgical area clean, avoiding strenuous activities for a period of time, and attending follow-up appointments as scheduled. Additionally, the doctor may recommend regular self-exams or screenings to monitor for any potential issues in the future.

Suitable For

Patients who are typically recommended undescended testicle surgery include boys with cerebral palsy who have a high incidence of undescended testis. The decision-making process for these patients is difficult due to the medical and surgical arguments involved as well as challenging ethical issues. Motives for treatment in these patients may include infertility, cancer prevention, psychological aspects, and testicular torsion.

Timeline

Before undescended testicle surgery:

  1. Diagnosis: The patient is diagnosed with an undescended testicle during a physical examination by a healthcare provider.

  2. Monitoring: The healthcare provider may monitor the undescended testicle over a period of time to see if it descends on its own.

  3. Consultation: The patient and their family may consult with a urologist to discuss the potential risks and benefits of surgery.

  4. Decision-making: The patient and their family make a decision on whether to proceed with surgery based on the recommendations of the urologist.

After undescended testicle surgery:

  1. Surgery: The patient undergoes surgery to correct the undescended testicle, which involves bringing the testicle down into the scrotum.

  2. Recovery: The patient will need time to recover from the surgery, which may involve pain management and restrictions on physical activity.

  3. Follow-up: The patient will have follow-up appointments with the urologist to monitor the healing process and ensure that the testicle remains in the correct position.

  4. Long-term outcomes: The patient may experience improved fertility, reduced risk of testicular cancer, and improved psychological well-being as a result of the surgery.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing surgery for an undescended testicle in a patient with cerebral palsy?
  2. How will the patient’s cerebral palsy affect the surgical procedure and recovery process?
  3. Will the patient require any special accommodations or post-operative care due to their cerebral palsy?
  4. How will having a surgical procedure impact the patient’s overall health and well-being, considering their neurological impairment?
  5. What are the long-term implications of leaving the undescended testicle untreated in a patient with cerebral palsy?
  6. Are there any alternative treatment options or considerations for managing an undescended testicle in a patient with cerebral palsy?
  7. How often should the patient follow up with their healthcare provider after undergoing surgery for an undescended testicle, particularly given their cerebral palsy?

Reference

Authors: Springer A. Journal: Sex Dev. 2019;13(1):20-25. doi: 10.1159/000496463. Epub 2019 Feb 1. PMID: 30703771