undescended testicle. UPDATED 12/22

[babygrant]

Has anyones child had an undescended testicle. My 6 week old does. Ped says if it doesn't drop by 9 months he'll start making arrangements for surgury. Anyone have any input on this?

I posted this on the life with babe board and was told to post it on here as well because i was told sometimes they perform circ's and they pull the foreskin back to insert a catheter and I do NOT want either of those done so I'm wondering how I would deal with that. I know with the circ I will just say DO NOT DO IT. But with the retraction issue...I won't be in the OR so how do I make sure it's not done?

[InDaPhunk]

Originally Posted by babygrant

i was told sometimes they perform circ's and they pull the foreskin back to insert a catheter and I do NOT want either of those done so I'm wondering how I would deal with that.

:

Make everyone involved signs an intact care agreement. I'm naking or I'd input more but I'm sure someone will be along to give you tons of info. You prolly need to have all this info just for routine medical care anyway as they loooove to mess with foreskins, it seems. I still have no clue what they'er looking for under there. A pot of gold, perhaps?

Hopefully, DS won't have to have surgery so it won't be an issue .

[InDaPhunk]

BTW, I think i heard the undropped testicle thing is pretty common and mostly resolves itself (?). I could be worng, though, it's been known to happen.

[MCatLvrMom2A&X]

Hi there, something that is very important is to get the dr to sign a no circ agreement soemone here can give u a link for one to print out. Also u need to make sure that u ? the dr on how they will do things ie the cathiter because they may not know how to deal with it. If u ask them if they know how to do cath with intact infant and they say yes. They may not really know. So ask them to describe exactly what they do. If they retract or not. The answer of course should be no. I am sure u will get good advice here. Many experts on this board. Good Luck

[Frankly Speaking]

You may be able to resolve the undescended testicle.

Some males have a testicle that can move up under the pubic fat mound, I know this well because mine will do that. There is a cavity above the penis and to each side of the penis where the testicle can retract. The solution can be very simple. With two fingers, start at the top of the pubic mound and gently massage downward past the penis on the side of the undescended testicle. Continue massaging downward to the scrotum. Sometimes the testicle will appear in the scrotum. We've had success with this method a couple of times before with mothers in this forum.

If that doesn't work and the surgery has to be performed, there are a couple of ways to avoid an internal catheter. The first is simply "bagging" him. A plastic bag can be taped on the penis to collect urine during the procedure. The other way is to use a male external catheter. These look like a condom with a tube coming out the end. It is placed on the penis and taped in place. This is something you will need to discuss with your pediatrician or urologist, which ever one will be doing the surgery. You need to discuss it at least a couple of weeks ahead of time just in case these are not kept in stock at the hospital.

You also need to give them fair warning that you can recognize the symptoms of forcible retraction (redness, swelling, stretch tears or blood) and will take appropriate legal action if these symptoms are present post surgery. That should take care of that.



Frank

[babygrant]

Thanks so much for the replies. All VERY helpfull.

Frank. I notice that the left side which is the undescended side...it does look like there is a testicle in there...but it's not as low as the other one. So if it was an undescended testicle, the left side would just be empty right?

Also, I will not be able to meet with the doctor who will perform the surgery until surgery day. We will need to drive 7 hours to Vancouver BC to have the surgery done at BC Childrens Hospital. So the first time I meet the doctor would be the day it's done.

I am going to show my husband this page because he is on the same boat as me. Thanks again for the help.

Angela

[+stella+]

Hi momma, I am in the same boat kinda. My son is still missing his right testicle, they say it is there but it hasnt moved down at all and he is now 15 months old. I missed his 1 year check but we go tomorrow for his 15 month, mostly for this reason alone. I know it needs taken care of but I am ABSOLUTELY dreading surgery. I go back and forth on how neccessary I really feel this is and how long is too long to wait, but I know I dont want to cause him fertility problems or possible testicular cancer by waiting to long either.

I am just like you in worrying about the retraction, my plan right now is to demand to be with him pre op when they insert a cath if he needs one, so i KNOW with my eyes they dont retract, and signing the no circ thing sounds like an excellent idea as well. My hospital doenst perform circs on neonates so.. I dont know, I am worried sick as well and just wanted to comiserate. I plan on having a LONG talk to the doc/surgeon as well, and if I feel like hes putting me off or is uncaring or rubs me the wrong way, hes gone, Ill pay for this **** out of pocket if I need to, I am NOT putting up with doctors who will talk above me or act like I should sit quietly and obey.

Gosh I have such a bad attitude already huh? Its sad, I just hope I find a doc that I can trust.

But for now, I wouldnt worry at this young age, his may come down on its own and I really hope it does for you. Youre a great momma for wanting to be prepared already.

[Quirky]

I know there have been threads on this before at MDC - I remember a discussion as to whether and when to perform surgery to correct the undescended testicle. Is there a reason it has to be done sooner rather than later? If it were me, I'd be inclined to wait until my son were older - fewer risks during anesthesia because of size, better communication about pain afterwards, better ability to understand what is going on, more time to let it resolve on its own.

My vague recollection is that the reason docs want to fix this is a) cosmetic and b) because of the risk that the undescended testicle may become cancerous later on. Both of these don't mandate surgery sooner rather than later IMO - but I haven't researched it so I don't know if there's something I'm missing.

[paminmi]

Please check out my message to another mom on this topic...some info that could be of use to you. Good luck!


http://mothering.com/discussions/sho...86#post2666586

[nd_deadhead]

My son was born with one undescended testicle. We were told that if it didn't come down on its own by the time he was a year old, we would talk about surgery. Turns out he had an inguinal hernia on the same side, and had an operation to correct that at 9 months. After that two things could have happened: the hernia repair could have made room for the testicle to descend, or scar tissue from the operation could prevent the testicle from coming down - we just had to wait and see. The testicle never did come down by itself, and my son had surgery at 15 months.

This all happened 10 years ago, and at the time it didn't occur to me to worry about circumcision or retraction. As far as I know, no one messed with my son's foreskin during any of his operations (he had a hernia repair on the other side when he was 3). But knowing what I know now, I would certainly bring it up with the surgeon.

My older brother had two undescended testicles, and didn't have surgery for it until he was 4 years old. He ended up being sterile - though of course it's impossible to know if it was because of the delayed operation or not.

[pjlioness]

Ds2 had an undescended testicle for a while. He was born at home and did not have much more than a cursory exam at birth, so I was the first one to notice it. When we went to the Dr. (GP - does homebirth and family care), he found it. I thought it was cool that I had known what it was first. The Dr. was totally unconcerned. I think it descended after a couple of weeks or so...I really don't remember.

[Dragonfly]

Originally Posted by Quirky

Is there a reason it has to be done sooner rather than later? If it were me, I'd be inclined to wait until my son were older - fewer risks during anesthesia because of size, better communication about pain afterwards, better ability to understand what is going on, more time to let it resolve on its own.

The main reason is potential sterility. The longer the testicle is up in the body cavity, the more likely it is to "die" from the body heat. My son had the surgery shortly after he turned 3 and it's probable that that testicle will always be smaller and non-functional (It definitely seems as though it's not growing. I'm still bothered by that. I wish we'd been able to get an accurate diagnosis sooner.)

The other reason is that undescended testicles are often accompanied by hernias, which are important to repair in order to avoid potentially dangerous complications.

It's pretty common for babies to have one or both testicles not be retracted at birth and come down on their own, so surgery very early is definitely not the way to go. It sounds like the OP's doctor is taking a wait and see approach, though, which is good.

I believe what Frank is referring to is a retractile testicle. This is where you can actually manually draw the testicle down into the scrotum.

About the catheter: My son didn't have one. As it was explained to me, they're not allowed to drink for 8 hours (I think?) before the surgery, so there's no need for one.

[Frankly Speaking]

Originally Posted by babygrant

Frank. I notice that the left side which is the undescended side...it does look like there is a testicle in there...but it's not as low as the other one. So if it was an undescended testicle, the left side would just be empty right?

No. During gestation, a boys testicles develop in the abdomen. Shortly before birth, they should descend down from this cavity into the scrotum. Undescended testicle just means the testicle hasn't descended into the scrotum. That lump or fullness you see is the testicle in the cavity. Since you can see where it is, try helping to descend by starting above what you can see and try gently massaging it down into the scrotum. It just may work.

Now, if it does work and if it dissapears again, you know that it can descend and that your son has retractile testicles and there is no problem with that. There is no medical intervention needed for retractile testicles.



Frank

[LeosMama]

This is interesting, so having retractile testicles up in the body for long periods of time won't cause sterility? how is this different from undescended testicles? in both situations, they are in the abdomen and are warm rather than cool.

[Frankly Speaking]

Originally Posted by LeosMama

This is interesting, so having retractile testicles up in the body for long periods of time won't cause sterility?

Apparently not. Mine move up and down freely and I think that may be germane. If I go swimming in cold water, they most likely will be in their hidey places or if I'm wearing tight pants or have my legs crossed. But a few minutes later, they come back down. I suspect that the longest they are retracted are maybe an hour or two but I've never paid much attention to it.

how is this different from undescended testicles? in both situations, they are in the abdomen and are warm rather than cool.

Undescended testicles are retracted all of the time. My best guess that in those, there is some diminished blood flow or testosterone is not able to get in or out and that is what causes sterility or cancer. The problem is I have never read anything that addresses this so I really just don't know.



Frank

[shannajoy]

My son is scheduled for surgery Jan 6th...

Originally Posted by Frankly Speaking

Apparently not. Mine move up and down freely and I think that may be germane. If I go swimming in cold water, they most likely will be in their hidey places or if I'm wearing tight pants or have my legs crossed. But a few minutes later, they come back down. I suspect that the longest they are retracted are maybe an hour or two but I've never paid much attention to it.

"Hidey places"?! That made me laugh out loud! :-) Thank you Frank, for your point of view on this. Those of us without testicles don't necessarily know these things.

My son had an undescended testicle at birth too. Seems like it has come down most of the way, but not far enough. He's scheduled for surgery on January 6th, to pull down the testicle on one side and drain fluid and check for a hernia on the other side. I hadn't even thought about retracting his foreskin to insert a cathedar, I'll have to ask about that in the pre-op review the day before the surgery. I know we'll get to be there when he goes under, and the operation will take about an hour. It is scary, but he'll be almost 14 months old and from what I've seen, if they aren't descended by about a year, they aren't likely to come down on their own. Cosmetically he'll look more "balanced" and hopefully the not-completely-descended testicle will grown normally, but I'm most concerned about his fertility.

[SagMom]

One of my sons has a retractile testicle.

We were told by one doc that it was undescended and would need surgery--That night (in the warm bathtub,) I found that both sides were down, so rather than seeing a surgeon, we saw another ped. He explained retractile testicle exactly as Frank did, and told us this was what was happening in our son--he said it would not effect sperm production and that no intervention was needed.

He also said that with a true undescended testicle, only the effected side would not produce sperm--so the male would not be sterile, he'd still produce viable sperm on the other side. The ped also told us that it did not make cancer more of a risk, but that IF the male had cancer, it would be more difficult to detect in an undescended testicle. (Some things to weigh against the risks and sucess rates of surgery.)

[Dragonfly]

Originally Posted by Joan

He also said that with a true undescended testicle, only the effected side would not produce sperm--so the male would not be sterile, he'd still produce viable sperm on the other side.

I should have made this clear in my post. Sterility is only a concern for the affected side. Of course, it's always better to have 2 working testicles than 1 in case something later happens to the 1 that works.

The ped also told us that it did not make cancer more of a risk, but that IF the male had cancer, it would be more difficult to detect in an undescended testicle. (Some things to weigh against the risks and sucess rates of surgery.)

That's actually contrary to everything I've read. A man is more likely to get cancer in an undescended testicle than in a descended one. Of course, it's not yet certain whether bringing it down surgically actually reduces the chance of getting cancer.

[Galatea]

I dated a guy with an undescended testicle. His parents got him surgery when he was 2 and they basically pulled the testicle down and stapled/fixed it into place. It was always high up in his scrotum just below his penis. He said it caused him pain b/c it naturally wanted to move around but was fixed in place and so he felt a pulling tight sensation occasionally, like if he was cold or sometimes sexually excited. It made him sad. Based on his story, he would probably say not to have the surgery. As I am married, though, and not to him, I don't think I could get you any more info.

[sbgrace]

Most children's will move down before 6 months. Don't worry--your son will probably be in that number. My son did have the surgery--at 18 months. I wish we would have done it earlier. My pediatrician thought it was coming down and it just never did. She messed up. It could impact his future fertility in that testicle--hopefully not but we fixed it later than it should have been fixed. They like to do them at 9-12 months because they start to detect cellular changes after that point.
If a child's testicle doesn't come down on it's own he is at a greater risk of cancer in both testicles. That is because it isn't about the testicle being there but rather why it didn't come down in the first place. The why is what increases the cancer risk. They bring it down so that a child who is at greater risk for that cancer can examine his testicles regularly--you can't feel for lumps if it is in your abdomen! I personally know someone with testicular cancer at 20. It is rare but it happens as we know.
So they bring down testicles to save fertility, for the look, and so that cancer (which the child would be at increased risk for) can be detected.
All that to say, though, that chances are your child will not be in this category and his testicle will come down on its own. If it doesn't, I would do the surgery....my son may not like a pulling sensation...but it will have still been the best choice (wish I didn't have it to make and it would have come down on its own).