Our Summary

The paper discusses the issue of nonpalpable testes, a condition where the testes cannot be felt through physical examination, which is a challenge for children’s urologists. There is not a consistent approach to deal with this situation, with different opinions on how to evaluate and manage it. The authors reviewed over 100 articles on the topic, covering research from 2000 to 2017. They found that the best way to identify the condition is through physical examination and that imaging is not needed in regular cases. The best surgical approach is still a matter of debate, with some new techniques being developed. The rarity of the condition makes it hard to conduct large scale comparisons and controlled trials, leading to ongoing controversy in its management. The authors suggest that future research should focus on collaborative trials across multiple institutions to find the best surgical treatment.

FAQs

  1. What is the best way to identify nonpalpable testes in children according to the reviewed research?
  2. Why is there ongoing controversy in the management of nonpalpable testes?
  3. What do the authors of the paper suggest for future research on the best surgical treatment for nonpalpable testes?

Doctor’s Tip

One helpful tip a doctor might give a patient about undescended testicle surgery is to follow post-operative care instructions carefully. This may include keeping the surgical area clean, avoiding strenuous activities, and taking any prescribed medications as directed. It’s important to attend follow-up appointments with your doctor to ensure proper healing and monitor for any complications. If you experience any unusual symptoms or have concerns, don’t hesitate to contact your healthcare provider.

Suitable For

Patients who are typically recommended undescended testicle surgery include those with nonpalpable testes, where the testes cannot be felt through physical examination. This condition is a challenge for children’s urologists, and the best way to identify it is through physical examination. Imaging may not be needed in regular cases, and the best surgical approach is still a matter of debate. The rarity of the condition makes it difficult to conduct large scale comparisons and controlled trials, leading to ongoing controversy in its management. Future research should focus on collaborative trials across multiple institutions to find the best surgical treatment for undescended testicles.

Timeline

  • Before surgery:
  1. Patient or parents notice absence of testicle in scrotum during infancy or childhood.
  2. Physical examination by a healthcare provider confirms the presence of an undescended testicle.
  3. Further evaluation may be done through imaging tests like ultrasound or MRI to locate the undescended testicle.
  4. Discussions with a pediatric urologist to determine the best course of action for surgery.
  • After surgery:
  1. Patient undergoes surgical procedure to bring the undescended testicle down into the scrotum.
  2. Recovery period post-surgery, which may include pain management and monitoring for any complications.
  3. Follow-up appointments with the pediatric urologist to assess healing and ensure proper placement of the testicle.
  4. Long-term follow-up to monitor for any potential issues or complications related to the surgery.

Overall, the timeline for a patient with an undescended testicle before and after surgery involves initial identification of the condition, evaluation, surgical intervention, and ongoing follow-up care to ensure the best possible outcome for the patient’s reproductive health.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with undescended testicle surgery?
  2. What is the success rate of the surgery in terms of bringing the testicle down into the scrotum?
  3. What is the recovery process like after the surgery and how long will it take for my child to fully recover?
  4. Are there any long-term effects or implications of having had undescended testicle surgery?
  5. What is the likelihood of the condition recurring after surgery?
  6. Are there any alternative treatment options or approaches to consider?
  7. How experienced are you in performing undescended testicle surgeries, and what is your success rate?
  8. Are there any specific precautions or steps that need to be taken before the surgery?
  9. Are there any lifestyle changes or restrictions that my child will need to follow after the surgery?
  10. How often should my child have follow-up appointments after the surgery to monitor their progress?

Reference

Authors: Shepard CL, Kraft KH. Journal: J Urol. 2017 Dec;198(6):1410-1417. doi: 10.1016/j.juro.2017.04.079. Epub 2017 Apr 21. PMID: 28434984