Symptoms
The children have no symptoms of undescended testicles as long as the long-term effects have not yet occurred. The only symptom is the non-palpable or invisible testicle, which is often noticed by the mother while changing diapers and leads to the doctor. Also the long-term consequences of undescended testicles are not directly noticeable.
Infertility is only noticed when the affected man wants to have children. A tumor of the testicle is often painless but only palpable through a thickened testicle. However, the aim should be to avoid these consequences and to treat undescended testicles in infancy.
Diagnostics
The diagnosis of undescended testicles is usually without problems, since an empty scrotum is clearly palpable. Such a palpation is performed in all male newborns at the initial check-ups and does not cause any pain in the testicles. Problems with the diagnosis can be caused by the sliding and the pendulum testis, since in some cases the testis is palpable.
In this case, a parent protocol on the position of the testicles has proven to be effective. A follow-up of the testicular descensus can be done by regular ultrasound of the testicle. If treatment of undescended testicles is necessary, it should be completed by the end of the second year of life to avoid possible secondary diseases.
The therapy of maldescensus testis usually begins in the first year of life. Until the end of the first year of life there is often still the possibility of a spontaneous descent, therefore in some cases it is waited even longer until a therapy is initiated. For the actual therapy of undescended testicles there is first of all the possibility of hormone treatment.
On the one hand, a nasal spray containing hormones (LH-RH nasal spray) can be applied to the infants. This can be given once daily for 28 days from the 3rd month of life.Alternatively, an intramuscular application of human chorionic gonadotropin (HCG) should be given weekly over a period of 4 weeks. If this hormone treatment does not lead to a descent of the testes, surgery is necessary, the so-called Operative Orchidopexy.
In this procedure the testicle is fixed to the scrotum so that it cannot slide into the inguinal canal. This should take place between the 9th and 18th month of life and be completed by the end of the second year of life. An exception to these therapies is the pendulum testis. This does not require any therapy if the position of the testis is predominant. If the testicles are missing due to undescended testicles, testicular implants can also be inserted.
