✓ Newborn with undescended testicle

In medical terms it is called cryptorchidism (from the Greek crypto: hidden, and orchis: testicle), and it is an anomaly in which the child is born with one or both testicles not visible in their seat - the scrotal sac - but not very hidden. above the scrotum or in the abdominal wall.

It is one of the most frequent congenital anomalies of the urogenital system of boys, affecting 3-5% of full-term births and 9-30% of preterm babies, as shown by a research conducted by the "Del Paeseno Study Group on the testicle felt ”, with the support of the Cultural Association of Pediatricians, the Institute for Infancy of Trieste, and the Pediatric Clinic of the University of Chieti. Here's how to tackle the problem.

Before 5-6 months it is not necessary to do anything. In some cases, by 5-6 months of life, the testicles descend by themselves; before this period therefore no treatment is necessary.

Hormone therapy is useless. After 6 months, some pediatricians, before referring to surgery, prefer to try a hormone therapy based on gonadotropins. "However, this therapy only works once out of four and among other things it is not free from undesirable effects, such as possible long-term adverse effects on spermatogenesis" is underlined in the research.

A little intervention is enough. The safest and most effective treatment to definitively resolve cryptorchidism is early surgery (orchidopexy), a minimally invasive intervention, which involves a small cut in the scrotum-inguinal area that brings the testicle back to the appropriate place. The operation is performed under locoregional anesthesia with small sedation and is carried out in day-hospital (or at most you stay in hospital for 48 hours).

Better not to postpone the surgery. International guidelines recommend carrying out the surgery between 6 and 12 months, exclusively in Centers with pediatric surgery or pediatric urology that have pediatric anesthetists. "In any case, it is better not to postpone the surgery until after two years" highlights the research: "a timely intervention not only allows a complete development of the testicles, but avoids consequences in adulthood such as reduced fertility, insufficient production of hormones up to tumor degeneration of the testicle ". It should be borne in mind that the testicles have been placed in nature in the scrotal sac, where the temperature is kept a few degrees lower than the body temperature precisely to preserve the vitality of these organs.

The benefit of early intervention is also psychological: at this age the child does not realize what is happening and will not keep any memory of what happened.

Not to be confused with the testicle in the elevator Cryptorchidism should not be confused with the entirely physiological phenomenon of the retractile testicle or in the elevator: in this case the testicles tend to temporarily rise to a higher location than their own, but it is possible to manually bring them back into the scrotum. The phenomenon tends to resolve itself as the child grows.