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Cryptorchidism (Undescended Testicles): Symptoms, Causes and Complications

An undescended testicle, also known as cryptorchidism, is a condition that is said to occur when the testes don’t move into the proper position after birth. Generally, during the last few months of pregnancy, particularly within the third trimester, a baby undergoes a lot of changes.

Changes such as the opening of the child’s eyes, the complete formation of the bones and bone marrow of the child, gaining of essential baby fat as well as many other changes are seen to occur in the child.

If your child is a boy, within the last trimester of your pregnancy, the testicles which originally are formed within the abdomen during the second trimester are seen to descend and enter into the scrotum (which is a pouch or fold of skin that is found just beneath the penis).

Every boy has two testicles that must descend into the scrotum from the abdomen before the child is born. However, in some cases, the testicles( either one or both of them) may not descend, and once this occurs, it may begin to pose problems to the child.

This condition is often very common, and sometimes, the testicles can descend on its own within six months. However, if it doesn’t, then the child may require the use of a surgical procedure to position the testicles in its right place.

Causes of Cryptorchidism (Undescended Testicles)

The exact cause of undescended testicles still remains unknown; however, some doctors attribute it to genes, the state of the mother’s health and sometimes environmental factors which can alter how the woman’s hormones and nerves function and as such, causing some developmental problems to the baby such as undescended testicles.

Asides these factors, some experts also think that the causes of undescended testicles may include:

  1. An earlier than expected birth
  2. Having a family member who has had the problem of undescended testicles or other genital issues.
  3. Some certain health conditions such as Down syndrome can affect the stages of growth and development of a particular fetus.
  4. Low birth weight can also be a contributing factor.
  5. Contact with harmful substances: If a pregnant woman comes in contact with some toxic substances such as pesticides, which are used to kill bugs or are often used on the farm.
  6. Obesity: If the mother is obese, it can affect the development of the child and cause developmental and genital problems such as undescended testicles.
  7. Diabetes: If a pregnant woman has diabetes, either type 1, type 2, or gestational diabetes, the child may likely have developmental problems such as undescended testicles.
  8. Intake of cigarettes and Alcohol: The I take of cigarettes and alcohol by a pregnant woman poses several issues for her and her baby, including genital problems such as undescended testicles.

Symptoms

How do you know that there is a problem with your male child, especially if he is having cryptorchidism (undescended testicles)? The first sign of undescended testes is the absence of the testicles in the scrotum.

Once you can’t see or feel the testicles in the scrotal sac of your male child, then there is a tendency your child may be suffering from undescended testicles. Usually, the testicles are formed within the abdominal region, and during the last trimester, the testis descends through a tube-like canal, which is known as the inguinal canal.

The inguinal canal serves as a passageway into the groin, and the testicles use this pathway to enter the scrotal sac. When the child has cryptorchidism, it means that either the testicles didn’t descend fully into the scrotal sac or it didn’t even start the process at all by leaving the abdomen.

Sometimes, the testicles may not be seen within the scrotal sac; however, the child doesn’t suffer from undescended testicles. Instead, the child suffers from what is known as retractile testicles.

Retractile testicles are said to occur when the testicles move up into the abdomen or the groin when the boy is cold or when he is scared. When this happens, the testes don’t stay in the groin; instead, it moves back on its own into the scrotum.

The difference between retractile testicles and undescended testicles is that in a person experiencing retractile testicles, the testicles move up and down on its own without the need for surgery.

In contrast, for a male experiencing undescended testicles, they will require surgery to reset the position of the testicles into the scrotal sac.

Complications of Cryptorchidism (Undescended Testicles)

The major reason why the testicles descend from the abdomen into the scrotal sac is that the testicles need a colder than average body temperature to function. This means that the temperature within the abdomen is the average body temperature, which is 37 degrees, and this is hotter than what is needed for the testicles to function.

Hence, if the testicles stay within the abdomen, they would lose their ability to function, and as such, they may develop certain complications.

The complications that can arise due to undescended testicles include;

1. Testicular Cancer

Testicular cancer often occurs when the cells of the testicles produce immature sperm. The major reason why this cancer occurs is not yet known.

However, it has been seen that most men who have testicular cancer have initially battled with undescended testicles, which causes them to have an increased chance of developing testicular cancer.

The risk of developing testicular cancer increases in men who have their testicles within the abdomen rather than in the groin. Also, when both testicles are affected, the male stands a higher risk of developing testicular cancer.

It is possible to correct the conditions of undescended testicles surgically. The surgery might even go a step further by decreasing the chances of developing testicular cancer; however, it doesn’t eliminate the possibility.

2. Fertility problems and possible infertility

Fertility problems such as low sperm count decreased fertility, as well as poor quality of the sperm, has been seen to occur mostly in men who have a case of undescended testicles.

Fertility problems can also be due to the abnormal development of the testicles, and it may even get worse if the condition is not treated on time.

If there is any delay in treating this condition, it may result to complete infertility of the male.

3. Testicular Torsion

Testicular Torsion occurs when the spermatic cord becomes twisted. The spermatic cord contains nerves, blood vessels(including arteries and veins), as well as the tube that helps in the transportation of semen from the testicles down to the penis.

Testicular torsion also causes severe pain to the patient and also cuts off blood supply to the testicle. If it isn’t treated quickly and immediately, it can cause the testicle to die off.

Testicular torsion occurs ten times in men that have undescended testicles than in men that have normal testicles.

4. Inguinal Hernia

Inguinal Hernia occurs when a portion of the intestines enter the inguinal canal. Sometimes, the space or gap between the abdomen and the inguinal canal becomes too large or too loose; a portion of the intestines can become trapped in that space, cutting off blood supply to the intestines and also a constriction.

When this occurs, an inguinal hernia is said to occur.

5. Trauma

If the testicle is found within the groin or within the abdomen, any possible trauma to the hip bone or the pubis can cause an injury to the testicle.

When to visit your doctor

It is advisable for you to visit your child’s doctor when you notice a problem with your baby’s genital organs. Generally, when a child is born, upon routine examination, the doctor will discover the abnormality.

Generally, if a child has undescended testicles at birth before the child is four months, the testicles might descend on its own. However, when your child is four months old, and the testicles don’t descend, then you need to revisit your child’s doctor.

When you treat an undescended testicle while the child is still a baby, it helps reduce or possibly prevent the risk of complications such as infertility and testicular cancer later in life.

Sometimes, some older boys(both teenagers and pre-adolescents) may appear to miss a testicle due to certain other conditions such as retractile testicles as well as ascended testicles.

References;

Deborah Akinola
Wirter, poet and public speaker

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