HOW do you tell the sex of your newly born? You glance at its privates. Often that is where it stops. But Dr. Patel Prakash advises parents to go ahead and feel their sonâ€™s scrotum for what he says is an increasingly common abnormality in men.
Undesended testicles (cryptorchidism) is a common condition at birth when one or both of the testes have not descended into the scrotum, but stay in the abdomen or only move part of the way down into the scrotum, says Prakash, a gynaecologist running a Fertility Endoscopy Clinic on Kisozi House.
Testes (testis, singular), commonly known as the testicles, are the male sex organs that are responsible for producing sperm and sex hormones. Both testes initially grow in the abdomen and then move down into the scrotum before or just after birth.
Prakash says parents should notify the doctor if their sonâ€™s scrotum feels empty. In many cases, the testicles will descend on their own before the child is three months old. But if they are not in the scrotum by six months of age, it is unlikely that they will descend by themselves and will require surgical intervention.
He said if undescended testicles are not brought back into the scrotum, they not only cause infertility, but may also turn cancerous.
What causes undescended testes?
Undescended testes can be unilateral (one) or bilateral (both), and are often found in babies with hormonal disorders, physical abnormalities at birth and genetic defects.
An Internet site on health, www.medicineplus.com says the condition can be acquired. A boy may be born with testes located in the scrotum, but later, they may occasionally move back out of the scrotum and into the groin when spermatic cords attaching each testis to the body, fail to grow at the same pace as the rest of the body, the site says.
But Dr. Tamale Ssali of the Kampala Gynaecology and Fertility Centre in Bukoto says this is rare. â€œIt is usually a hormonal disturbance during pregnancy and most people are born with it,â€ he says.
Doctors also say that in about 5% of cases, testes donâ€™t descend because they are dead. It is thought that with failure of testicular descent, an interrupted blood flow may cut off supply to the developing testis, killing them as the baby is developing. Absent (or vanished) testes can also be associated with other birth defects of the urinary system, such as abnormal blood vessel networks to the tubes that carry sperm.
How common is it?
www.medicinet.com says undescended testes are more common in premature male babies because the testes do not descend from the abdomen into the scrotum until the eighth month of pregnancy.
Prakash says some people have it but donâ€™t know. â€œThere is a time a woman told me she could feel only one testicle in her husbandâ€™s scrotum. â€˜Arenâ€™t they supposed to be two?â€™ she asked. One of the husbandâ€™s testicles was partially descended and he had never noticed it.
Since they had children and the condition was painless, it took a lot of convincing for the gentleman to go for an operation.â€
Maybe men should check their scrotums to see if both â€˜seedsâ€™ are there. Nonetheless, Prakash says that undescended testes can only be confirmed by a qualified medical practitioner.
Regular testicular self-examination is also recommended for men born with undescended testes, especially to check for lumps or swellings that could be a sign of testicular cancer.
Why should undescended testes be corrected?
At whatever age, Prakash says, the testicles must be brought down. Leaving them up may lead to cancer because the testicle is developing in an unusual environment,â€ Ssali says.
It also leads to infertility. Men born with bilateral undescended testes are reported to have very poor sperm quality, even after correction by surgery. The temperature in the scrotum is lower than in the abdomen and sperm-producing tubes in the testes function better at a cooler temperature. â€œBringing the testes down into the scrotum between six to 12 months of age can improve semen quality and fertility later in life,â€ Ssali says.
Undescended testes are trapped in an abnormal position which exposes them to a higher risk of injury or torsion (twisting and cutting of blood supply). A testis in the scrotum has more mobility and is less likely to be injured in ordinary activity.
The condition is associated with hernia and can develop a hernia sac, which is a lump that appears when tissue breaks through a weakened area of the abdominal wall.
As boys age, body image becomes more important, especially during teenage years. Abnormal testes can have a negative impact on the boyâ€™s confidence and self-esteem. Placing the testis in the scrotum makes the boy look normal.
Does your baby have both testicles?