A Morning of Concern and Reassurance
It was an unusually breezy Tuesday morning at the clinic. The sun filtered through the blinds, casting warm, gentle lines across the waiting room. I was sipping my first cup of tea for the day, allowing the comforting warmth to settle my mind. My phone buzzed briefly, a message from my brother reminding me about dinner plans later that week. As I tucked my phone away, the doorbell chimed, signaling the arrival of my next patient.
When I stepped into the waiting area, I saw Mark, a tall man with salt-and-pepper hair, cradling his eight-month-old son, Ethan. Ethan’s soft babble was punctuated with a hiccup of fussiness, and Mark’s face wore the look of quiet concern mixed with exhaustion.
“Good morning, Dr. Priya,” Mark said, trying to smile but not quite managing. His grip on Ethan was tender, but I could tell his mind was elsewhere.
“Morning, Mark,” I replied warmly. “Come on in. What’s on your mind today?”
As we settled into the consultation room, Mark sighed, his eyes flicking between me and Ethan. “I’m worried, Priya. I was changing Ethan’s diaper last night, and I noticed one of his testicles doesn’t seem to be where it should be. It wasn’t there before, but I thought it would settle on its own. Now, I’m not so sure.”
I nodded, already understanding his concern. Let’s take a look,” I said softly, knowing that Mark needed reassurance just as much as Ethan needed care.
What is an Undescended Testicle?
After a gentle examination, I explained, “Mark, Ethan’s condition is called cryptorchidism or an undescended testicle. It’s when one or both of the testicles haven’t moved down to the scrotum by birth. This is actually more common than you’d think. Around 4% of newborn males have this issue, and it’s even more frequent in premature babies – up to 25%.”
Mark’s brow furrowed. “Is it serious?”
I smiled gently. “Most cases resolve on their own within the first three months of life. By the time a baby is six months old, the testicles have usually descended into the scrotum. But if it hasn’t happened by now, it’s something we need to monitor more closely. There’s no immediate cause for panic, but early intervention is key if the problem doesn’t resolve.”
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Why Does This Happen?
Mark listened intently as I continued. “We don’t know exactly why undescended testicles happen. During pregnancy, the testicles develop inside the abdomen and gradually descend into the scrotum before birth. For some babies, that process doesn’t complete. It can be congenital, meaning the baby is born with it, or it can happen later, known as acquired undescended testicle. Sometimes, the testicles start in the correct position at birth but later ascend into the groin.”
I paused, giving him time to absorb the information. “There’s no fault here, Mark. It’s not something you or your wife did or didn’t do. It just happens.”
What are the Symptoms and Risks?
I could see Mark was worried, so I addressed his concerns directly. Undescended testicles usually don’t cause any pain or discomfort. You wouldn’t know unless you noticed the scrotum looks underdeveloped or one testicle doesn’t seem to be in place.”
“But what happens if it doesn’t come down?” he asked quietly.
“Good question,” I replied. “If left untreated, there can be some risks. One concern is fertility. The undescended testicle can affect sperm production because the temperature inside the abdomen is higher than in the scrotum. There’s also a slightly higher risk of testicular cancer later in life. The risk of cancer is about 10 times higher than normal, but early treatment reduces this risk significantly.”
I saw a flash of worry cross his face, so I reassured him. “We’re catching this early, Mark. The key is to address it within the first year or two.”
Treatment Options
“So, what can we do?” Mark asked, bouncing Ethan gently on his knee.
“First, we’ll keep an eye on it,” I explained. “Sometimes, the testicle will descend on its own by 12 months. If it hasn’t, we’ll consider a simple surgical procedure called orchidopexy. The surgery involves bringing the testicle down into the scrotum and fixing it in place. The ideal time for surgery is between six and 12 months, and most surgeons prefer to do it at 12 months.”
Mark’s shoulders relaxed slightly. “Is it a big procedure?”
“Not at all,” I assured him. “It’s a straightforward, day-surgery procedure. The recovery is usually quick, and the success rates are very high. In some cases, if the testicle remains undescended by school age, the surgery can still be done, but it’s best not to delay too long.”
Reassurance and Next Steps
Mark looked down at Ethan, who had found a fascination with the buttons on his shirt. “I just want him to be okay.”
“He will be,” I said, placing a hand on Mark’s arm. “You did the right thing by bringing him in. We’ll schedule a follow-up in a couple of months. If the testicle still hasn’t descended by then, we’ll plan for surgery.”
Mark smiled for the first time that morning. “Thank you, Priya. It’s good to know he’s in safe hands.”
As he left the clinic, I watched him lift Ethan high into the air, the baby’s laughter filling the room. Moments like these reminded me why I do this – not just to provide medical care, but to ease the hearts of worried parents.
Key Points About Undescended Testicles
- Common Condition: About 4% of newborn males and 25% of premature males are affected.
- Types: Congenital (present at birth) and acquired (develops later).
- Symptoms: One or both testicles not palpable in the scrotum.
- Risks: Reduced fertility and a slightly higher risk of testicular cancer if untreated.
- Treatment: Observation until 12 months, followed by surgical correction (orchidopexy) if needed.