Materiały źródłowe

• #1 Undescended Testicles (Cryptorchidism): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17594-undescended-testicles

  During pregnancy, testicles develop in the abdominal cavity. In most cases, they drop into the scrotum before birth. Undescended testicles dont drop before birth. If the testicles dont descend after six months, your child may need surgery or hormone therapy. […] Undescended testicles are when the testicles fail to drop into the scrotum before birth or in the first few months of life. […] Without treatment, undescended testicles can be serious. They can lower your childs testosterone levels and affect their sperm health. […] If your childs testicles havent dropped by the time theyre 6 months old, talk to a healthcare provider about treatment. If your child needs an orchiopexy, providers recommend they get it between 12 and 24 months of age. […] If testicles dont drop into the scrotum, they may not function properly or produce healthy sperm. They can cause infertility later in life.

• #2

  https://www.nhs.uk/conditions/undescended-testicles/

  Undescended testicles are a common childhood condition where a boy’s testicles are not in their usual place in the scrotum. […] In most cases no treatment is necessary, as the testicles will usually move down into the scrotum naturally during the first 3 to 6 months of life. […] But around 1 in 100 boys has testicles that stay undescended unless treated. […] Undescended testicles aren’t painful and your child isn’t at risk of any immediate health problems, but they should be monitored by a doctor in case treatment is needed later on. […] If the testicles haven’t descended by 6 months, they’re very unlikely to do so and treatment will usually be recommended. […] This is because boys with untreated undescended testicles can have fertility problems (infertility) in later life and an increased risk of developing testicular cancer.

• #3 Outbreaks, Alerts and Hot Topics: Undescended Testicles: Steps to Follow Prior to Urology Referral | Children’s Mercy Kansas City

  https://www.childrensmercy.org/health-care-providers/refer-or-manage-a-patient/connect-with-childrens-mercy/newsletter-the-link/link-newsletter-april-2023/outbreaks-alerts-and-hot-topics-undescended-testicles/

  Undescended testicles (cryptorchidism) and retractile testicles are reasonably common findings in the primary care setting. The prevalence of retractile testicles in school age boys is estimated to be between 4% and 13%. The true incidence of undescended testicles, after the third month of life when they are most likely to spontaneously descend, is about 1%. Testicles that are undescended cannot be brought down into the scrotum and are often felt within the inguinal canal. Retractile testicles can be brought down into the scrotum by manipulation but retract into the inguinal canals by cremasteric contraction. American Urological Association (AUA) guidelines suggest that primary care providers should palpate for quality and position of the testes at every well-child visit. To ensure that undescended testicles are properly identified, it is important to get a good scrotal exam. When testicles cannot be easily seen or palpated in the scrotum, it is helpful to assess for retractile versus undescended testicles. If the testicle cannot be manipulated into the scrotum or if it quickly returns to the inguinal canal even after an attempt to fatigue the cremasteric muscle, it is likely undescended. This condition will require further evaluation by urology. Patients with undescended testicles should be referred as soon as possible and within six months of discovery. Infants with undescended testicles should be referred if the testicle has not descended by 6 months of age as it is unlikely to descend after this age. Any undescended testicles that persist after 6 months of age are unlikely to descend spontaneously and need to be referred to urology. Scrotal ultrasounds are not needed prior to a urology referral for undescended testicles. […] When in doubt, refer to urology or reach out to us for a consult.

• #4 Cryptorchidism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470270/

  Cryptorchidism, the most prevalent congenital condition involving male genitalia, is characterized by the absence of at least one testicle from the scrotum; this often manifests unilaterally or bilaterally, with a higher frequency of involvement observed in the right testicle. Approximately 3% of full-term and 30% of premature male infants are born with undescended testicles, necessitating a nuanced understanding among healthcare professionals. […] If the testis has not descended by 6 months, surgical correction through orchiopexy is recommended to minimize risks and potential complications. […] Participants in the course gain a comprehensive understanding of the condition’s diagnosis, management, and long-term implications. […] They learn about the various diagnostic techniques, including palpation, imaging studies, and hormonal assays, enabling them to accurately identify undescended testicles and assess their location.

• #4 Cryptorchidism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470270/

  Furthermore, participants explore the multidisciplinary approach to cryptorchidism management, recognizing the critical role of collaboration among different healthcare professionals. […] By engaging with experts from various specialties, including urology, pediatric surgery, endocrinology, and primary care, participants understand how interdisciplinary collaboration enhances patient care outcomes. […] According to the AUA guidelines, healthcare professionals are advised against hormonal therapy to induce testicular descent, citing low response rates and a lack of long-term efficacy. […] The primary hormone utilized for hormone therapy is hCG. […] Surgery is recommended promptly following diagnosis for acquired undescended testes (those identified as normal before diagnosis) and entrapped undescended testes (those occurring after hernia repair).

• #4 Cryptorchidism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470270/

  For palpable undescended testes, performing an inguinal or scrotal orchiopexy is recommended. […] The selection of a surgical approach depends on the surgeon’s specific training, experience, skill level, and personal preference. […] With proper diagnosis and treatment, the prognosis for cryptorchidism is excellent. […] However, there is a slight increase in the risks of testicular cancer and infertility compared to the general population. […] Patients and their families should be informed by their clinician about the nature and natural progression of untreated cryptorchidism, emphasizing early surgery recommendations.

• #5

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Undescended-Testicles.aspx

  Before birth, a baby boy’s testes (testicles) develop inside the abdomen. Closer to delivery, these organs travel through a canal in the groin. When all goes as it should, the testicles then fall into place in the scrotum, the bag of skin beneath the penis. […] In some boys, especially those who are born premature, one or both testicles do not make it down to the scrotum before birth. This is known as cryptorchidism, more commonly called undescended testicles. For babies born with this condition, the testicles sometimes descend on their own usually by 6 months of age. In other cases, treatment or surgery is needed. […] Undescended testicles are diagnosed through physical examination. At every well-child visit, the doctor will do a genital examination to check the location of the testicles.

• #5

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Undescended-Testicles.aspx

  If your child’s testicle has not come down into the scrotum on its own by 6 months of age, they will likely need treatment. It is relatively rare for undescended testicles to fall into proper position after 6 months of age. So, there is usually little value to waiting. […] Instead, the current approach to treatment involves surgery to relocate the testicle into the scrotum. This surgical procedure is called an orchiopexy. It may need to be performed in a two-stage manner depending on the location of the testicle. […] Since the chances of the testicle coming down on its own is slim after 6 months old, your child should be referred for treatment once they’ve reached that age. Waiting beyond 2-3 years may hinder the testicle’s ability to grow and function normally. Ideally, orchiopexy should be done within the first 18 months of life. […] Pediatricians and pediatric urologists work together to care for boys with undescended testicle. Boys who may need surgery are referred to a pediatric urologist.

• #6 Undescended testes

  https://www.rch.org.au/kidsinfo/fact_sheets/undescended_testes/

  Testes (testicles) are male sex glands. They produce sperm and hormones for sexual reproduction. The testes are usually situated in the scrotum, but sometimes one or both of the testes do not move down into the scrotum once they develop. This is called undescended testes, and is also known as cryptorchidism. […] About five per cent of male babies are born with undescended testes. […] The main sign of undescended testes is one testis (a single testicle) or both testes missing from the scrotum. Undescended testes will not cause your child any problems with urination, and will not cause any pain, unless the cord attached to the testis (spermatic cord) becomes twisted. […] If your baby is born with undescended testes, this will be picked up by your Maternal and Child Health Nurse or your doctor shortly after birth. Your baby’s condition will be monitored.

• #7 Undescended Testicles (Cryptorchidism) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/undescended-testes-cryptorchidism

  Undescended testicles, also known as cryptorchidism, is a fairly common and normally painless congenital condition in which one or both of a baby’s testicles (testes) have not moved into the proper position. […] If your son’s testicle does not descend on its own before his first birthday, his surgeon will most likely recommend a type of surgery called orchiopexy to move the testicle down into the scrotum. […] Surgery is highly recommended in order to reduce the risk of cancer or infertility, to improve your son’s body image through adolescence and adulthood, and to reduce long-term effects and the risk of cancer or infertility. […] Orchiopexy moves the testicles into the scrotum, where they’re about three to five degrees cooler than they would be if they remained inside the abdominal cavity. This improves the chances of fertility later in life.

• #7 Undescended Testicles (Cryptorchidism) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/undescended-testes-cryptorchidism

  Undescended testicles may increase the risk of infertility, especially if both testicles are affected. However, boys who have one undescended testicle tend to father children at the same rate as those who are not affected by the condition at all. […] Boys who have two undescended testicles a much lower percentage of patients do have a significantly lower fertility rate. […] The surgeons at Boston Children’s are experts in the surgical treatment of undescended testicles and are committed to making your son’s genital area look as normal as possible.

• #8 Undescended testes

  https://www.rch.org.au/kidsinfo/fact_sheets/undescended_testes/

  If your baby’s testes were in the scrotum at birth, and one or both of them disappears from the scrotum, see your GP. You will be referred to a paediatrician or paediatric surgeon. It is very important that the testes be brought down to the scrotum. […] If the testes do not come down, there is a risk of ongoing health issues such as: Torsion the spermatic cord can become twisted and this can cut off the blood supply to the testes. Hernia when a loop of bowel comes into the scrotum. Reduced fertility the body temperature in the abdomen is higher than in the scrotum, and this can affect sperm production in the testes. Risk of testicular cancer this happens in a relatively low number of boys. The risk is usually less than 1 in 100. Poor self-esteem due to having abnormal looking genitals. […] For babies born with undescended testes, the testes may come down by themselves in the first three months after birth, and no treatment is needed.

• #9 Undescended Testes (Testicles; also Cryptorchidism) | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/undescended-testes-testicles-also-cryptorchidism/

  In most cases, your child will do home from the recovery room on the day of surgery. […] Follow-up appointments will be scheduled to monitor progress and ensure proper healing. […] The risk of testicular malignancy in patients with a history of UDT is five to 10 times greater than the general population with descended testes.

• #10 Undescended testicles | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/undescended-testicles

  a boy with undescended testicles is at increased risk of inguinal hernia (abnormal bulging in the groin area) […] Undescended testicles that are not brought into the scrotum from a young age will not produce sperm. […] The risk of testicular cancer is five to 10 times higher for males with undescended testicles than for the general male population. […] Surgery is the best treatment for undescended testicles. […] Research suggests that future sperm quality in the affected testicle is compromised if the condition is corrected after the child is two years old. […] Surgery to relocate the testicles inside the scrotum is called orchidopexy. […] In about five per cent of cases of undescended testicles, surgeons cant find the missing testicle.

• #11 Undescended Testicles (Cryptorchidism) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/cryptorchidism.html

  An undescended testicle is more likely to form a tumor than a normally descended testicle. […] The undescended testicle may be more at risk for injury or testicular torsion. […] An asymmetrical or empty scrotum can cause a boy worry and embarrassment. […] Sometimes boys with undescended testicles develop inguinal hernias. […] If surgery is done, it’s likely to be an orchiopexy (or-kee-oh-PEK-see). In this procedure, a small cut is made in the groin and the testicle is brought down into the scrotum, then fixed (or „pexed”) in place. […] Most doctors believe that boys who’ve had a single undescended testicle will have normal fertility and testicular function as adults, while those who’ve had two undescended testicles might be more likely to have reduced fertility. […] Boys who’ve had undescended testicles should have regular follow-up appointments with a urologist to make sure that no problems develop.

• #11 Undescended Testicles (Cryptorchidism) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/cryptorchidism.html

  Undescended testicles (also known as cryptorchidism) is a condition in which one or both of a baby boy’s testicles (testes) have not moved down into their proper place in the scrotum. […] If a testicle has not descended on its own by the time a baby is 6 months old, he should be checked by a pediatric specialist and have treatment if the condition is confirmed. This usually involves surgically repositioning the testicle into the scrotum. […] Treatment is necessary for several reasons: Being up in the body means the undescended testicle is at a higher temperature than usual (testicles need to be below regular body temperature to produce sperm). The higher temperature may harm the testicle’s development and its ability to make sperm in the future. This could possibly lead to infertility (the inability to father children).

• #12 Undescended Testicle | Texas Children’s

  https://www.texaschildrens.org/content/conditions/undescended-testicle

  Cyptrorchidism (also known as undescended testicle) occurs when 1 or both testicles fail to move into the scrotum before birth. It occurs in approximately: 10% of premature infants, 3% of full-term infants, 0.8% of boys at 6 months of age, 0.8% of boys during puberty. This condition occurs when testicles develop inside a fetus’ abdomen but do not descend to the scrotum during his mother’s pregnancy. Undescended testicles can be part of a larger syndrome or, most commonly, an isolated finding. The cause remains unknown and is believed to include both genetic and environmental risk factors. Perinatal risk factors include prematurity, low birth weight, breech presentation and maternal diabetes. Problems associated with undescended testicles include: inguinal hernia, risk of infertility, tumor and testicular torsion. Diagnosis is made solely by physical exam. The doctor will observe the shape and appearance of the scrotum, then feel or press with his hands to determine whether the testcle is palpable or nonpalpable and where it is located. No intervention is needed for retractile testicles. True undescended testicles diagnosed after 6 months of age need to be corrected with surgery or hormonal injections. Palpable testicles will be corrected with a small incision in the groin on the affected side. The testicle is found and released from any attachments; any hernia sac found will be closed. An additional incision is made in the scrotum, the testis is pushed into the scrotum and a stitch anchors it in place. Boys with nonpalpable testis generally undergo laparoscopic exploration, which consists of looking into the abdomen with a small camera to identify the testicle if present. Once identified, the testicle will then be placed in the scrotum in one or two stages (orchiopexy). Hormonal treatment of undescended testes has limited success and is not generally suggested in the US. After surgery, your son will usually be discharged home the same day. His doctor will prescribe pain medicine for his discomfort, but children’s acetaminophen or ibuprofen is also helpful. He should not take a full bath for 3 days. He should also avoid straddling toys such as bicycles, walkers and bounce toys, and strenuous activities for 2-3 weeks following the surgery. There can be abnormal semen found in 50% of adults with a history of 1 undescended testicle, and in 75% of those with a history of 2 undescended testes. Actual fertility is minimally lower than the general population if only one side is involved. If both testes are undescended the occurrence of infertility is higher. Patients with undescended testicles have a higher but undefined risk of testis tumor. Regular testicular self-exam is important after reaching puberty for these adolescents and men as it is for all men.

• #13 Undescended Testicle | Children’s Hospital Pittsburgh

  https://www.chp.edu/our-services/urology/conditions/undescended-testicle

  An undescended testicle, sometimes called a cryptorchid testicle, is a common problem in young boys. […] There are several reasons that we recommend treatment for persistently undescended testicles. […] Bringing the testicle into the scrotum early might preserve these cells and, therefore, improve chances for fertility in the future. […] Second, testicles that are undescended have a higher risk of developing testicular cancer than those that descended spontaneously. […] A third reason to fix undescended testicles is because of the hernia that is often associated with them. […] Treatment for the undescended testicle depends on the location of the testis. […] This operation is almost always performed as an outpatient. […] Recovery is generally very rapid and success can be expected to be good.

• #14 2 Cryptorchidism (Undescended Testes) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cryptorchidism-undescended-testes-nursing-care-plans/

  Use this nursing care plan and management guide to help care for patients with cryptorchidism. Learn about the nursing assessment, nursing interventions, goals and nursing diagnosis for cryptorchidism in this guide. […] The focus of nursing care planning in clients with cryptorchidism (undescended testes) is to provide preoperative and postoperative care, give emotional support regarding body image, decrease anxiety, and prevent the occurrence of complications. […] Goals and expected outcomes may include: Parents verbalize decreased anxiety about the child’s undescended testes. The client will not experience any signs of infection. The Parents/child will identify measures to reduce the risk of infection. The client/caregivers will understand and demonstrate behaviors or methods to avoid skin breakdown or help the healing process.

• #14 2 Cryptorchidism (Undescended Testes) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cryptorchidism-undescended-testes-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with cryptorchidism may include: Assess origin and anxiety level and how it is expressed; need for information that will alleviate anxiety. […] The risk of infection for a child with cryptorchidism is increased due to inadequate primary defenses, such as broken or irritated skin in the area surrounding the undescended testes. […] Educate caregivers on skin and wound assessment and watch out for signs and symptoms of infection, complications, and healing. Early assessment prompts immediate intervention thus preventing the occurrence of complications.

• #15 Evaluation and Treatment of Cryptorchidism (2018) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/cryptorchidism-guideline

  Providers should obtain gestational history at initial evaluation of boys with suspected cryptorchidism. (Standard; Evidence Strength: Grade B) […] Primary care providers should palpate testes for quality and position at each recommended well-child visit. (Standard; Evidence Strength: Grade B) […] Providers should refer infants with a history of cryptorchidism (detected at birth) who do not have spontaneous testicular descent by six months (corrected for gestational age) to an appropriate surgical specialist for timely evaluation. (Standard; Evidence Strength: Grade B) […] Providers should refer boys with the possibility of newly diagnosed (acquired) cryptorchidism after six months (corrected for gestational age) to an appropriate surgical specialist. (Standard; Evidence Strength: Grade B)

• #15 Evaluation and Treatment of Cryptorchidism (2018) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/cryptorchidism-guideline

  Providers must immediately consult an appropriate specialist for all phenotypic male newborns with bilateral, nonpalpable testes for evaluation of a possible disorder of sex development (DSD). (Standard; Evidence Strength: Grade A) […] Providers should not perform ultrasound (US) or other imaging modalities in the evaluation of boys with cryptorchidism prior to referral as these studies rarely assist in decision making. (Standard; Evidence Strength: Grade B) […] Providers should assess the possibility of a disorder of sex development (DSD) when there is increasing severity of hypospadias with cryptorchidism. (Recommendation; Evidence Strength: Grade C) […] Providers should not use hormonal therapy to induce testicular descent as evidence shows low response rates and lack of evidence for long-term efficacy. (Standard; Evidence Strength: Grade B)

• #15 Evaluation and Treatment of Cryptorchidism (2018) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/cryptorchidism-guideline

  In the absence of spontaneous testicular descent by six months (corrected for gestational age), specialists should perform surgery within the next year. (Standard; Evidence Strength: Grade B) […] In prepubertal boys with palpable, cryptorchid testes, surgical specialists should perform scrotal or inguinal orchidopexy. (Standard; Evidence Strength: Grade B) […] In prepubertal boys with nonpalpable testes, surgical specialists should perform examination under anesthesia to reassess for palpability of testes. If nonpalpable, surgical exploration and, if indicated, abdominal orchidopexy should be performed. (Standard; Evidence Strength: Grade B) […] At the time of exploration for a nonpalpable testis in boys, surgical specialists should identify the status of the testicular vessels to help determine the next course of action. (Clinical Principle) […] Providers should counsel boys with a history of cryptorchidism and/or monorchidism and their parents regarding potential long-term risks and provide education on infertility and cancer risk. (Clinical Principle)

• #16 Cryptorchidism (Undescended Testes) Nursing Care Management

  https://nurseslabs.com/cryptorchidism-undescended-testes/

  Cryptorchidism, also known as undescended testes, is a common congenital anomaly in male infants where one or both testicles fail to descend into the scrotum before birth. This nursing notes provides an overview of cryptorchidism, discussing its prevalence, clinical manifestations, diagnostic evaluation, treatment options, and the significance of early detection and timely management to promote normal testicular development and reproductive health in affected individuals. […] Nursing care of a child with cryptorchidism includes the following: […] Assessment of the child involves: […] Physical examination is the most important tool in the diagnostic evaluation of cryptorchidism; the patient must be examined in a warm, relaxed environment; closely observing the scrotum before manipulation is important; the frog-leg or catcher position may be used to facilitate palpation of the testis.

• #16 Cryptorchidism (Undescended Testes) Nursing Care Management

  https://nurseslabs.com/cryptorchidism-undescended-testes/

  Based on the assessment data, the major nursing diagnoses are: […] Deficient knowledge related to the condition and surgery. […] The major goals for the patient are: […] The family caregivers will be able to verbalize an understanding of the condition and the surgical intervention. […] The nursing interventions appropriate for the patient are: […] Understanding the surgical treatment. Determine the child’s expectations regarding illness and hospitalization through discussion and play therapy; explain the anatomy and physiology of the urinary system in terms the child can understand; use a body outline appropriate for the age of the child, and explain all diagnostic tests before their occurrence. […] Preventing infection. Administer antibiotics and I.V. fluids as ordered; maintain patency of catheters; provide catheter care as directed; administer wound care using aseptic technique, and inspect incision for drainage or signs of infection. […] Goals are met as evidenced by: […] The family caregivers verbalized understanding of the condition and the surgical intervention.

• #17 Undescended testicle – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/undescended-testicle/diagnosis-treatment/drc-20352000

  Even after surgery, it’s important to check your baby’s testicles to make sure they develop properly. You can check the position of the testicles during diaper changes and baths. […] Your child’s doctor will check the groin. If a testicle isn’t in the scrotum, the provider will try to find it by lightly pressing against the skin. A lubricant or warm, soapy water may be used for the exam.

• #17 Undescended testicle – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/undescended-testicle/diagnosis-treatment/drc-20352000

  With an undescended testicle, surgery may be needed to find the problem and treat it. There are two main types of surgery: […] The goal of treatment is to move the undescended testicle to its proper place in the scrotum. Treatment before age 1 might lower the risk of health problems linked with an undescended testicle, such as infertility and testicular cancer. Earlier treatment is better. Experts often recommend that surgery take place before the child is 18 months old. […] Most often, an undescended testicle is fixed with surgery. The surgeon moves the testicle into the scrotum and stitches it into place. This is called orchiopexy (OR-kee-o-pek-see). It can be done through a small cut in the groin, the scrotum or both. […] After surgery, the surgeon monitors the testicle to see that it develops, works right and stays in place. Monitoring might include: Physical exams. Ultrasound exams of the scrotum. Tests of hormone levels.

• #18 Undescended Testis | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/u/undescended-testis

  It is important to explain that „retractile testicles” are not undescended testicles. If a testicle can be brought down into the scrotal sac, even if it bounces back up again upon release, it is a retractile testis. These retractile testicles are in the scrotum at other times and do not need treatment. […] If an undescended testicle is not corrected, the following problems may occur as the male child grows up: […] There are two treatment options: hormonal and surgical. […] In cases in which both sides are undescended, hormonal treatment may aid the testicles descent into the scrotum. The hormone human chorionic gonadotropin (hCG) is given as an injection over several weeks. It cures undescended testes about 10 percent to 15 percent of the time. Surgery may still be needed. […] Your surgeon will give you instructions on how to care for the surgery site.

• #19 Undescended Testicle Causes and Treatment | UPMC

  https://www.upmc.com/services/urology/conditions/undescended-testicle

  Undescended testicles are almost always associated with hernias. […] Treatment for the undescended testicle depends on the location of the testis. […] For testes that can be felt in the groin area, the usual recommendation is an operation called anorchiopexy or orchidopexy. […] This surgery is almost always performed as an outpatient procedure. […] An alternative is hormonal treatment with HCG, a series of injections that stimulate the testicles to make hormones. […] If the testicle cannot be felt by the doctor, it is called an „impalpable” testis. […] Unfortunately, there is no reliable x-ray that can tell us whether a testis is in the abdomen. […] The most accurate operation to locate these testicles is a laparoscopy, a procedure in which a telescope is placed into the abdomen through a small incision near the navel.

• #20 Undescended testicles: Why prompt referral is key

  https://answers.childrenshospital.org/undescended-testicles/

  As tempting as it may be to send the patient for an ultrasound prior to referring them to a urologist, Dr. Nelson urges prompt referral to a specialist instead. […] That’s important because the longer the wait before surgery, the higher the risk of complications the child may experience down the road. Potential complications include fertility issues, hormonal problems, and testicular cancer. Current practice is to surgically correct undescended testicles by 18 months of age. […] For Dr. Nelson, the most important take-home message to pediatricians who suspect undescended testicles for any infant or child is to immediately refer them to a urologist without hesitation.

• #21 Undescended testicle (cryptorchidism) | University of Iowa Health Care Stead Family Children’s Hospital

  https://uihc.org/childrens/health-topics/undescended-testicle-cryptorchidism

  A testicle left in the abdomen may be at increased risk for injury or torsion (twisting and cutting of its blood supply). […] Placement of the testicle in the scrotum makes the scrotum look normal. […] Since some testicles that are not descended at birth will come down, it is best to wait until around 6 months of age. By this age if a testicle cannot be felt or is very high, it is unlikely that it will come down. […] In most cases the child will go home on the same day the surgery is performed. A small incision is made in the groin and on the scrotum. No stiches will need to be removed. […] Laparoscopy involves making an incision in the abdomen and placing a lighted telescope through this incision to look for the missing testicle. If it is found (some testicles are absent), laparoscopy is used for bringing it down into the scrotum.

• #22 Undescended Testes in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=undescended-testes-in-children-90-P03081

  Undescended testes is when one or both of the male testes have not passed down (descended) into the scrotal sac. This is a condition seen in some newborn baby boys. […] Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. In many cases, the testes descend on their own into the scrotum by age 3 months. In most cases, the testes pass down by age 6 months without any treatment. […] In other cases, treatment may be needed. This may include: Surgery. The undescended testicle may be moved into the scrotal sac with surgery. This surgery is called orchiopexy. It’s often done between ages 6 and 18 months. It works for most children. […] In other cases, surgery or hormone therapy may be needed. […] If testes don’t descend, this can cause problems such as infertility, higher risk of testicular cancer, and other problems.

• #23 Cryptorchidism – Wikipedia

  https://en.wikipedia.org/wiki/Cryptorchidism

  When the undescended testis is in the inguinal canal, hormonal therapy is sometimes attempted and very occasionally successful. The most commonly used hormone therapy is human chorionic gonadotropin (hCG). A series of hCG injections is given and the status of the testis/testes is reassessed at the end.

• #24 Undescended testes: What general practitioners need to know

  https://www1.racgp.org.au/ajgp/2019/january%E2%80%93february/undescended-testes

  If a testicular nubbin is found, there is some controversy around mandatory removal because of a potential risk of malignancy. […] Hormonal treatment with gonadotrophin-releasing hormone or human chorionic gonadotropin has been investigated but has not proven efficacious in promoting testicular descent. […] The risk of testicular cancer has been approximated at 2% in UDT; although this is four to five times the risk in the general population, parents can be reassured this is still relatively low. […] Decreased fertility is largely a concern for bilateral UDT. Malignancy occurs at a higher rate but remains relatively low risk.

• #25

• #26 Current Management of Undescended Testes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4856300/

  Orchiopexy has been the mainstay of treatment for cryptorchidism in the US. […] The timing for initial referral and subsequent surgical correction has been debated. […] Therefore, referral to a surgical specialist for congenital cryptorchidism should occur at 6 months (corrected for gestational age), to facilitate correction within the next year. […] Bilateral non-palpable testes, which occurs in about 20-30% of patients with cryptorchidism, requires additional workup for disorders of sexual development (DSD). […] Cryptorchidism is a relatively common finding in boys which should be actively screened for in both the newborn and pediatric populations.

• #26 Current Management of Undescended Testes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4856300/

  Undescended testes (UDTs) are a relatively common finding in newborn males, especially in those born prematurely. Upon discovering a non-intrascrotal testis, it is important to determine whether the testis is palpable or non-palpable and whether the finding is unilateral or bilateral. […] Patients with UDTs diagnosed after 6 months of age should be referred to a specialist for correction so that surgery may be performed within 1 year thereafter. This allows testes to descend spontaneously if they are to do so while facilitating early intervention to decrease the risk of subfertility and testicular malignancy for those patients in whom spontaneous descent does not occur. […] The surgical approach is often dependent on the location of the testis on physical exam. Most orchiopexies for palpable testes are performed through an inguinal incision, although a scrotal approach can be safely utilized depending on the testis position.

• #27 Undescended Testicle (Orchiopexy) Repair Surgery

  https://www.chp.edu/our-services/surgery-pediatric/patient-procedures/undescended-testicle-orchiopexy-repair-surgery

  This surgery is done to move a young boys testicles from his abdomen, or tummy, into the scrotum (SKROT-um), the sac of skin that holds the testicles on the outside of the body. […] Undescended testicles may not cause pain, but they may cause swelling or a lump in the groin area (the place where the lower abdomen meets the inner thigh). If not corrected surgically, the undescended testicles may cause infertility and other medical problems later in life, including the development of tumors or hernias. The area is also more vulnerable to injury if not corrected. […] The surgery to move the undescended testicle into the scrotum is done under general anesthesia. General anesthesia makes your childs whole body go to sleep and is needed for the surgery so that his reflexes will be completely relaxed. General anesthesia makes the surgery easier and safer to do because your child will not feel any pain or have any memory of it.

• #27 Undescended Testicle (Orchiopexy) Repair Surgery

  https://www.chp.edu/our-services/surgery-pediatric/patient-procedures/undescended-testicle-orchiopexy-repair-surgery

  Caudal anesthesia is given with general anesthesia to block pain in the low back, tummy and lower trunk area and provides up to 4 hours of pain relief in that area after the surgery. […] The most important role of a parent or guardian is to help your child stay calm and relaxed before the surgery. The best way to help your child stay calm is for you to stay calm. […] After your child is discharged and goes home, he might still be groggy and should take it easy for the day. […] Your child should take Tylenol or Motrin 4 hours after the surgery, which will help with discomfort when the anesthesia wears off. Pain medication is rarely needed after 2 days. […] The incision should not be soaked for about 5 days. […] After the operation, activity needs to be somewhat restricted.

• #28

  https://www.nhs.uk/conditions/undescended-testicles/treatment/

  Your child may feel a bit unwell for the first 24 hours after surgery as a result of the anaesthetic. […] The success rate for treating palpable testicles located near the scrotum is estimated to be higher than 90%. […] The operation is slightly less successful in treating impalpable testicles located in the abdomen. […] As with any type of surgery, an orchidopexy carries the risk of complications, some of which may need to be treated with further surgery. […] Possible side effects and complications of an orchidopexy include: bleeding, swelling or bruising where the incisions were made, the wound becoming infected, the testicle moving up into the groin again, the blood supply not being able to sustain the testicle in its new position, which causes it to wither away (testicular atrophy), damage to the tube connecting the testicle to the urethra (vas deferens), which can make it difficult for semen to pass through. […] In general, complication rates are low. The main risk is loss (atrophy) of the testicle.

• #29

  https://medschool.cuanschutz.edu/surgery/divisions-centers-affiliates/pediatric/patient-care/orchidopexy

  The ability to bring the testicle into the scrotum is limited by the length of the testicular artery. […] A testicle that cannot be found in the groin or the scrotum may be in the abdominal cavity. […] The only way to establish with certainty that a testicle is completely absent is by direct visualization of blind-ending testicular vessels and a blind-ending vas deferens. […] If the testicle is present but is atrophic (wasting away), it should be removed. […] If the testicle is healthy, it may be relocated via orchidopexy.

• #29

  https://medschool.cuanschutz.edu/surgery/divisions-centers-affiliates/pediatric/patient-care/orchidopexy

  Male fertility (the ability to father children) in the setting of an uncorrected one-sided undescended testicle ranges between 40-65%. In comparison, fertility in a one-sided undescended testicle that is repaired before six years of age is about 80-90%. […] Orchidopexy is a surgical procedure that moves an undescended testicle into the scrotum. The operation is performed to reduce the risk of crush injury, correct the associated hernia, and/or alleviate the psychological concerns of having only one testicle visible in the scrotum. […] An orchidopexy does not, however, protect against the 8-10 fold increased incidence of testicular cancer in patients with a history of undescended testicle. […] Orchidopexy does, however, offer a crucial benefit: by moving the testicle into the scrotum, it makes it much easier to monitor for signs of cancer in the future.

• #30

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zy1328

  After surgery, your child may feel tired. Your child will need to recover in a crib or bed for a few days. Let your child return to normal activities when your child seems ready or when your doctor says it is okay. This is usually in 2 or 3 days. […] Your child may also have pain, swelling, or bruises in the groin area. Medicines can help with pain. Swelling or bruising should start to go away 2 to 3 weeks after surgery. […] Follow the steps below to make sure your child gets better as quickly as possible. […] Let your child rest in bed for a few days. Sleeping will help him recover. […] Have your baby or toddler avoid doing any tumbling for a few days. Have your child avoid doing straddling activities, such as riding a tricycle or using a sit-on toy, for 3 to 4 weeks. […] Do not let your child do intense exercise, such as sports, running, or physical education at school, for 4 to 6 weeks.

• #31

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zy1328

  Your child may shower or have a sponge bath the day after surgery. Do not let him swim or have a bath for 5 to 7 days. […] Your child should be able to go back to school or daycare in 2 or 3 days. […] Have your child drink plenty of fluids for the first 24 hours to avoid becoming dehydrated. […] When your child is ready to eat, start with foods that are easy to swallow. […] Avoid giving your child steamy, hot, spicy, or hard and crunchy foods, such as chips or waffles. […] If your child has not had a bowel movement after a couple of days, call your doctor or nurse advice line. […] Always wash your hands before touching the incision area. […] Wash the area daily with warm, soapy water and pat it dry. […] Keep the area clean and dry. […] Follow-up care is a key part of your child’s treatment and safety. […] Call your doctor or nurse advice line now or seek immediate medical care if: Your child has pain that does not get better after he takes pain medicine. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if your child has any problems.

• #32 Nursing Care Plan For Undescended Testes – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-undescended-testes/

  A comprehensive nursing assessment for a patient with undescended testes is essential to identify potential risks, assess the impact on reproductive health, and develop a tailored care plan. […] These nursing diagnoses provide a foundation for developing a comprehensive care plan for individuals with undescended testes. Tailored interventions can then be implemented to address the identified issues and promote the overall well-being of the patient. […] These nursing interventions aim to address the physical, emotional, and educational needs of individuals with undescended testes, fostering a holistic and patient-centered approach to care. […] In conclusion, the nursing care plan for undescended testes, or cryptorchidism, is crafted to provide a comprehensive and patient-centered approach to addressing the complex physical, emotional, and educational needs associated with this congenital condition. […] Ongoing follow-up and monitoring strategies are integrated into the care plan to track the success of interventions, assess for potential complications, and address any emerging developmental or reproductive health concerns.

• #32 Nursing Care Plan For Undescended Testes – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-undescended-testes/

  Undescended testes, also known as cryptorchidism, is a congenital condition characterized by the failure of one or both testicles to descend into the scrotum. A nursing care plan for undescended testes is essential to address the unique challenges associated with this condition, emphasizing early detection, timely intervention, and comprehensive support. This care plan aims to provide a structured framework for healthcare professionals to deliver evidence-based care, promote informed decision-making, and optimize outcomes for individuals affected by undescended testes. […] By integrating assessments, interventions, and education, the care plan strives to address both the physical and psychosocial aspects of undescended testes. The focus is on promoting proper testicular descent, preventing complications, and supporting the individual and their family throughout the diagnostic and treatment process.

• #33 Undescended testes

  https://www.rch.org.au/kidsinfo/fact_sheets/undescended_testes/

  If the testes do not come down by themselves, your child will be monitored, and if they are not down after six months, an operation called an orchidopexy is needed. An orchidopexy brings the testis down into its normal location in the scrotum. Orchidopexy is done under anaesthesia. […] After your child’s surgery, you will be given some post-operative care instructions. […] Limit your child’s activity for the first few days after surgery the surgeon will advise you of when your child can return to their normal activities. […] An appointment will be made for your child to see their surgeon after the operation. Regular checks may be needed to make sure the testicle remains in the scrotum. Your child will need to learn how to do regular testicular self-examination when they become a teenager. […] Undescended testes is when the testes are not in the scrotum. […] An operation is needed if the testes do not move down by themselves by six months of age. This is done to reduce ongoing health issues. […] The operation is a day procedure and your child will usually go home the same day.

• #34 Recovery & Support for Undescended Testicles | NYU Langone Health

  https://nyulangone.org/conditions/undescended-testicles-in-children/support

  NYU Langone pediatric urologists offer guidance to the families of boys who have had surgery to correct undescended testicles. […] The success rate for surgery to correct undescended testicles is greater than 96 percent. […] Treatment before age 2 is recommended to help lower a boys risk of developing changes in the testicle that can possibly result in infertility. […] Although surgery may reduce the risk of testicular cancer, it does not eliminate it. […] Our doctors understand that you may have concerns about your childs reproductive health in the future. […] Boys who have had surgery to correct two undescended testicles may experience infertility in adulthood, depending on the location of the testicles prior to surgery.

• #35 Surgery for Undescended Testicles | NYU Langone Health

  https://nyulangone.org/conditions/undescended-testicles-in-children/treatments/surgery-for-undescended-testicles

  NYU Langone doctors typically recommend a follow-up visit 10 to 14 days after surgery. During this appointment, they determine if your child is feeling better and healing well. The stitches used to close the incision are dissolvable. […] Another follow-up visit is usually scheduled for about four months after surgery. This allows the doctor to reexamine your child.

• #36 Undescended testicle – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/undescended-testicle/symptoms-causes/syc-20351995

  A testicle that doesn’t move down into its proper place in the scrotum before birth is called an undescended testicle. It’s also known as cryptorchidism (krip-TOR-kih-diz-um). Most often, it’s just one testicle that doesn’t descend into the scrotum, which is the bag of skin that hangs below the penis. But sometimes both testicles are affected. […] If your baby has an undescended testicle that doesn’t correct itself, surgery can be done to move the testicle into the scrotum. […] Treating an undescended testicle when your child is still a baby might lower the risk of health problems later in life. These include cancer of the testicles and not being able to get a partner pregnant, also called infertility. […] Surgery to correct an undescended testicle might lower the risk of testicular cancer. But the cancer risk doesn’t go away completely. […] Fertility problems might be worse if an undescended testicle goes without treatment for a long time. […] Talk to your child’s doctor or other member of their care team if you notice any changes in your child’s genitals or if you have other concerns.

• #37 Pediatric Undescended Testes – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/undescended-testes

  Hormone therapy. Certain hormones may trigger the body to make testosterone. This helps the testes descend into the scrotal sac. This treatment is only used in some cases. Talk with your childs healthcare providers about the risks, benefits and possible side effects of all medicines. […] If testes dont descend, this can cause problems such as: Infertility. This is most common when both testes dont descend. […] Risk for testicular cancer. This risk increases greatly by age 30 or 40. Men with undescended tests will need to do monthly testicular self-exams. […] Emotional stress. An empty scrotum can cause emotional upset to boys and men.

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