Cryptorchidism in a child: photo, treatment, what is the procedure, reviews

Cryptorchidism in children - a congenital abnormality in boys in which are in the scrotum are not omitted one egg, and sometimes both. They can remain in the inguinal canal, in the abdomen or in the upper part of the scrotum. It's a common disorder in pediatric urology, which affects about 4% of full term boys, and about 20% of preterm infants. Such a big difference in percentage stems from the fact that testicles descend into the scrotum late in pregnancy, just before birth. If labor begins prematurely, this phenomenon to happen did not. But most children by the end of the first year of life, the problem disappears by itself as the testicles descend into the scrotum on their own. In other cases it may require surgical intervention as in the future undescended testes can lead to serious consequences such as infertility and cancer.

Photo of cryptorchidism in children

Below are the visual materials that help to imagine what it looks like affliction.

It is important to know what is the disease in order to identify and begin treatment.

Classification

Depending on the location of the testes cryptorchidism klassificeret as:

• Abdominal - when the egg is discovered in the abdominal cavity. When Troubleshooting sometimes even ultrasound cannot detect the location of the testicle. Treated only operational method.
• Inguinal - in the location of the testicle in the groin area.
• One sided - when not dropped one testicle.
• Bilateral cryptorchidism in children - when popestii two testicles in the scrotum. Sometimes occurs when hormonal disorders at the stage of fetal development. In this case it is important to start treatment as soon as possible, without waiting for the action of hormonal therapy, as in bilateral popestii cell death involved in the production of sperm is about 70 %.

In most cases, be detected right cryptorchidism.

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There are:

• True form - when the undescended testes were discovered immediately after birth
• About cryptorchidism in children - when at birth, the testes were in the scrotum Alpinopolis, but after some time the doctor was able to identify their correct location. This form of cryptorchidism requires treatment and takes place in early puberty boy.
• Ectopia of the testicle when the testicles descended but not in scrotum, and unusual for this region (groin, pubic area, perineum, thighs, etc.). This often occurs due to mechanical obstacles. Unfortunately, in this form of the disease even after treatment, most of the boys remains barren.
• Recurrent cryptorchidism - pathology, in which, because of the lag of development of the spermatic cord, the testicles re-ascend up out of the scrotum

After the classification of cryptorchidism a physician decides on the further treatment of the child.

Causes of cryptorchidism

At this time, unknown the exact causes of this disease. The doctors isolated a number of factors that may cause such anomalies in babies:

• Chromosomal disorders;
• Genetic predisposition;
• Premature birth;
• Hormonal disorders in mother during pregnancy (diabetes, disorders of the thyroid gland);
• Multiple pregnancy;
• The toxic effects on the fetus (alcohol, Smoking, the medications that are prohibited during pregnancy);
• Viral diseases during pregnancy;
• Narrow the inguinal passage or short spermatic cord, etc.;
• More than 80 % of cases of neofuscelia egg coincides with the presence of congenital inguinal hernia.

If in the period of carrying a child revealed at least a couple of the above factors is required to more closely monitor the baby's development.

It is Proved that the observance of a mother mode of rest and nutrition the risk of cryptorchidism in children is significantly reduced.

Methods for diagnosis of cryptorchidism

The Presence of the boy cryptorchidism diagnose urologist. To define this pathology, as a rule, is not difficult. For diagnostics using the following methods:

• Inspection and palpation of the scrotum, inguinal region. It is very important that the room was warm as in a cool room may occur reflexively raising the testicles due to muscular contraction.
• If on examination, the physician notes the absence of one or two testicles, is appointed ultrasound examination of the inguinal and abdominal areas with use of Doppler imaging.
• In more severe cases, it may be recommended procedure MRI or CTE (mostly this analysis is prescribed when you suspect that the complete absence of one or two testicles).
• Blood test for hormones.
• Sometimes recommended for diagnostic laparoscopy.

It Should be noted that palpation of the testes should hold still in the hospital. And if there is popushina, in the certificate of discharge indicates this diagnosis. But an inattentive inspection of this body part in a child leads to the fact that children are discharged without specifying the presence of this problem. In this regard, parents may not know until a certain age that their son needs to be controlled and treatment. When you have a running cryptorchidism, the boy may have problems. It is therefore recommended to explore the groin of the kid, in time to see a specialist.

Symptoms of cryptorchidism

Here's what you need to pay attention:

• When viewed in the scrotum is not palpable, one or two eggs.
• Dragging pain in the groin. But pain or discomfort during urination is not observed, no newborn babies, no more boys.
• When probing, you can detect the egg in the abdomen, in the thigh or in the perineum.
• The asymmetry of the genital organs.

Complications of cryptorchidism

It is Important to understand that cryptorchidism is a very serious disease that requires mandatory treatment. The most dangerous complications of the disease include:

• Injury of the testicle. When the uncharacteristic location of the egg can be damaged by even slight tap at him.
• Inguinal hernia, which can be a serious threat to the life of a boy (threat of infringement).
• Neotominae testicle sometimes becomes the seat of inflammatory processes.
• Hormonal disruptions. In cryptorchidism the child is the suppression of male hormones.
• Torsion of the testis. This complication needs urgent surgical intervention. It is characterized by acute pain and a blood disorder.
• Infertility. For the production of sperm requires a certain temperature, which is present in the scrotum. If the egg is in a different area of the body (high temperature), it breaks down the process of sperm production. There are cases when the sperm ceases to be produced at all.
• Testicular Cancer. With the development and lack of treatment within the body there are mutations that can trigger the development of malignant tumors.

When cryptorchidism the risk of infertility increased by 70 % of cases, and testicular cancer is 80 %.

Note that the above complications can occur with total disregard for the treatment or late detection. Otherwise, this illness is quite curable.

Treatment

The Treatment of cryptorchidism in children begin in the undescended testicle after the age of six months. But mostly, if at birth one or both testicles not in the scrotum, they go there until the baby was one month old. In preterm infants, this period may be extended to 12 months. At this time a very important control of the physician.

The Treatment of cryptorchidism in children possible in two ways:

• Conservative;
• Operational.

The conservative method is assigned to the medical treatment of hormonal drugs. Use intramuscular administration of hormones such as gonadotropin-releasing hormone and HCG. In addition, the endocrinologist prescribes some vitamins.

As a result of this method of treatment of prolapse of the testicles can be achieved in 50-60 % of cases. But some doctors do not recommend to apply this method in children with unilateral cryptorchidism, where one testicle is healthy and functioning normally, since large doses of HCG can negatively influence the process. During intensive hormonal treatment can begin early puberty.

When false cryptorchidism together with hormonal therapy, the doctor may try to lower the testicle into the scrotum by palpation.

If the conservative treatment does not yield results, is surgery, called orchiopexy. Treated cryptorchidism in children operation in age not earlier than 2 years. But some experts insist on Prov...