HCMCA 2-year-old boy, in Ben Tre, recently his parents could not see the testicles in the scrotum, so he was taken to the Children’s Hospital 2.
Dr. Pham Ngoc Thach, Deputy Director of Children’s Hospital 2, on March 15, said doctors diagnosed the baby with hidden testicles, the ability to be in the abdomen because the examination could not be touched, the ultrasound did not play. show testicle position.
Family members said that after giving birth, one side of the baby’s scrotum could not see the testicles. About a year old, a baby’s testicles are palpable, sometimes not.
Doctor Thach and Dr. Le Nguyen Yen, Deputy Department of Urology had laparoscopic surgery for the baby, found the testicles in the abdomen. Doctors removed the testicles, helping to bring down the correct position of the scrotum where the blood vessels supplying the testicles as well as the vas deferens system are not damaged.
After surgery, the testicles are in the correct position in the scrotum, the incision is clean. The boy recovered well, just discharged from the hospital one day after surgery.
According to Dr. Thach, this technique requires a lot of qualifications and experience of the surgeon because if trying to lower the testicles, accidentally stretching the perfusion system, will reduce blood supply. This is one of the causes of testicular atrophy after a patient grows up. In addition, if you try to bring down the testicle state is too stretched, it will easily lead the testicles to return to the starting position, ie the disease recurs.
“This pediatric case is very special,” said Dr. Thach. Family members have once touched the testicles, proving the ability of the testicles to move and the level of mobility is quite high, the amplitude is wide, so sometimes in the scrotum, sometimes in the groin and even back to the hole. deep groin, abdominal cavity. For hidden, mobile testicles, testicular torsion is always one of the pending risks to note.
During the embryonic period, the testicles move from the abdomen through the abdominal wall in the groin into the normal position of the scrotum. If there is a problem in this process, not in the scrotum but in the abdomen, in the groin, it is called the hidden testicle.
Hidden testicles are present in 30% of preterm births. With full-term babies, the probability is only about 3%. In children with hidden testicles, about 70% of cases the testicles will fall into the scrotum in the first months, but after one year, the percentage of testicles hiding into the scrotum is very small or insignificant.
To recognize the hidden testicles, it is easiest when the baby stands and feels the scrotum without seeing the testicles; When the baby lies and feels on the groin area, a small bulge can be seen moving. When you see the above phenomenon, parents should take the baby to the pediatric hospital to be examined by a doctor.
If untreated, the hidden testicles will lead to many unfortunate consequences. If a child has hidden testicles, suddenly, severe cramping in the groin area is painful and the child does not allow it to touch; sometimes vomiting is accompanied by testicular torsion. Testicular torsion due to the testicle is not fixed in the scrotum as usual and the testicles must be removed if necrotic.
The risk of malignancy of a hidden testicle is 22 to 40 times higher than that of a normal testicle located in the scrotum. If the testicles are in the abdominal cavity, the risk of chemistry is further increased due to higher intra-abdominal temperature in the scrotum, preventing the testicles from growing and reducing the number of germ cells. In addition, when the opposite testicle is hidden, the opposing testicle also has a 25% risk of malignancy.
Cases of latent testicles until after puberty, usually the testicles are atrophied and located high in the abdomen, testicles should be removed because the testicles have lost function and to prevent the risk of malignancy.
Unilateral or bilateral hidden testicles impair fertility. Data show that only 25% of cases of bilateral hidden testicles who have had surgical treatment have normal sperm counts. Infertility is unavoidable in those with bilateral hidden testicles without treatment.
One study found that the rate of having children is 90% at 1-2 years of age, 50% at 2-3 years, 40% at 5-8 years old, 30% at 9-12 years old, and only 15% when over 15 years old.