The most common genital abnormality present at birth in male babies is cryptorchidism, or an undescended testicle.
About four percent of all boys are born with this condition, although the rate is much higher if the baby is born prematurely. Approximately thirty percent of premature boys will be born with cryptorchidism.
- Most of the time, the testicle will descend on its own by the boy’s first birthday.
- If not, surgical intervention is recommended.
What Causes an Undescended Testicle?
The testicles are formed in the abdomen of a developing fetus. They do not usually descend into their correct position until shortly before birth, which is the reason premature babies are more at risk for the condition. Placement of the testicles is checked by the physician shortly after birth. If both testicles are not found, the baby is diagnosed with cryptorchidism. Further examination can determine if the testicle never formed, or if it has become shriveled from a blockage in the testicular vessels. These causes are rarer, however.
Normally, it is just a matter of the testicle not descending properly. It may be just above the scrotum or still in the abdomen. A retractile testicle will move back and forth from the scrotum to the groin and will usually resolve itself by puberty. If the testicle is brought down during the exam but then retracts again, the physician may diagnose it as retractile.
What Are the Risks of Not Fixing the Testicle?
In males, the scrotum keeps the testicles at a cooler temperature than the rest of the body. Higher temperatures in the abdomen can reduce the normal production of sperm, leading to fertility issues in the future. A testicle that is out of place is also more prone to twisting and injury. This can lead to embarrassment for the child. The risk of testicular cancer is higher in boys born with an undescended testicle. When the testicle is in the proper position, it is easier to monitor for changes relating to malignancy.
How Can a Physician Fix an Undescended Testicle?
In most cases, especially if there are no underlying causes that are initially seen, a physician will opt to observe the testicle for the first year of life. More than half of boys born with an undescended testicle will need no further intervention and the testicle will descend by the first birthday. If this hasn’t occurred by the age of one, the testicle will need to be surgically brought down and affixed into place.
An orchiopexy is the surgical treatment of choice. A small cut is made into the groin, allowing the surgeon to pull the testicle down and into place. It is then fixed into place in the scrotum, or pexed. A surgical fix of cryptorchidism should not need to be repeated later in life.