Our Summary

This research paper discusses undescended testis, a common genital disorder identified at birth. If a boy’s testis does not naturally descend by the age of 6 months (considering the time they were born), they should be referred to a children’s urology specialist for a procedure known as orchiopexy. The paper also notes that retractile testes, which are testes that can move back and forth between the scrotum and the groin, are at risk of permanently moving upwards and should be checked annually. If there’s a risk that the testis might move upwards, a visit to a children’s urology specialist is recommended. The paper also adds that most cases of phimosis (a condition where the foreskin is too tight to be pulled back over the head of the penis) can be managed with medication and gently pulling back the foreskin.

FAQs

  1. At what age should a boy with an undescended testis be referred to pediatric urology?
  2. What is the recommended treatment for most cases of phimosis?
  3. How often should retractile testes be monitored by physical examination?

Doctor’s Tip

One helpful tip a doctor might tell a patient about undescended testicle surgery is 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 and dry, avoiding strenuous activities for a certain period of time, and taking prescribed medications as directed. It is also important to attend follow-up appointments with the doctor to monitor recovery progress and address any concerns or issues that may arise.

Suitable For

Patients who are typically recommended for undescended testicle surgery include boys who do not have spontaneous descent of the testis at 6 months of age, adjusted for gestational age, as well as those with retractile testes at risk for secondary ascent of the testes. Additionally, cases of phimosis that cannot be managed medically with topical corticosteroids and manual retraction of the foreskin may also require surgery. Referral to pediatric urology is recommended for all of these cases to ensure timely and appropriate management.

Timeline

  • Before surgery:
  1. Birth: A baby boy is born with one or both testicles not descended into the scrotum.
  2. 6 months: If the testicle(s) have not descended on their own, the pediatrician refers the child to a pediatric urologist for evaluation.
  3. Evaluation: The pediatric urologist examines the child and determines the best course of action, which may include surgery.
  • After surgery:
  1. Surgery: The child undergoes orchiopexy surgery to bring the undescended testicle(s) down into the scrotum.
  2. Recovery: The child may experience some discomfort and swelling after the surgery, which can be managed with pain medication and rest.
  3. Follow-up: The pediatric urologist monitors the child’s recovery and checks for any complications or recurrence of the undescended testicle.
  4. Long-term care: The child may need regular follow-up appointments to ensure the testicle(s) remain in the scrotum and to monitor for any potential issues with fertility or other complications.

What to Ask Your Doctor

  1. What is the recommended timing for undescended testicle surgery in my case?
  2. What are the potential risks and complications associated with the surgery?
  3. How long will the recovery process take, and what can I expect during this time?
  4. Will the surgery affect my fertility in the future?
  5. What are the alternatives to surgery for treating an undescended testicle?
  6. How will the surgery impact my child’s future risk of testicular cancer?
  7. Will my child need any follow-up or additional care after the surgery?
  8. Are there any lifestyle changes or precautions my child should take post-surgery?
  9. What should I do if I notice any concerning symptoms or complications after the surgery?
  10. Are there any long-term effects or considerations to be aware of after undescended testicle surgery?

Reference

Authors: Huen K, Richardson S. Journal: Adv Pediatr. 2024 Aug;71(1):169-179. doi: 10.1016/j.yapd.2023.12.001. Epub 2024 Jan 6. PMID: 38944481