Cryptorchidism is a condition when a baby boy is born without one or both testicles (testicles) in the scrotal sac. This condition is thought to be experienced by 1 in 25 baby boys. Cryptorchidism is more at risk in babies who are born prematurely.
Cryptorchidism is also called undescended testis , which means the testicles do not descend. This is because cryptorchidism occurs due to a delay or cessation of the process of the descent of the testes from the abdominal cavity into the scrotum (scrotum).
Causes of Cryptorchidism
The process of formation and development of the testicles in the uterus is divided into two phases. The first phase takes place in early pregnancy, when the testicles are formed in the abdominal cavity which is influenced by androgen hormones. In this first phase, problems are generally rare.
The next phase begins at the age of 7 months of pregnancy. In this phase, the testicles that have been formed will gradually descend from the abdominal cavity to the scrotum through the inguinal canal that runs along the groin.
Most cases of cryptorchidism occur in the second phase. A testicle that has formed does not descend, either because it remains in the inguinal canal, in the wrong place (ectopic), or rises back into the inguinal canal after previously descending (retractile).
Although it rarely happens, not descending or not finding the testes in the scrotum can also be caused by abnormalities in the formation of the testicles that occur in the first phase. This causes the testes to not form, so they are not found in the scrotal sac or in the inguinal canal.
The exact cause of cryptorchidism is not known. However, genetic and environmental factors are thought to influence the occurrence of cryptorchidism.
Some conditions that can increase the risk of cryptorchidism in children are:
- Born prematurely or with low birth weight
- Have a family history of cryptorchidism
Meanwhile, the risk of cryptorchidism in children can increase if pregnant women have the following conditions or factors:
- Exposure to chemicals, such as pesticides, diethylstilebestrol, or plastic-making materials such as phthalates and dioxins
- Smoking habits or exposure to secondhand smoke
- Consumption of alcoholic beverages
Cryptorchidism symptoms
The testicles are a pair of glands in the male reproductive system. This organ functions to produce sperm and the hormone testosterone . This gland is oval like an egg, soft textured, and covered by a skin sac called the scrotum.
Under normal conditions, the testicles will descend and hang below the abdomen, to be precise in the middle of the groin and behind the penis. This gland needs to hang outside the body because sperm production requires a lower temperature than body temperature.
In cryptorchidism, one or both testicles are not present in the scrotum at birth. This condition can be immediately recognized by a doctor by looking at or feeling the scrotal area, both when the baby is born and during routine checks.
Cryptorchidism has no characteristic symptoms. This condition does not cause pain or urinary disturbances in children. However, cryptorchidism that is not handled properly can cause interference with sperm production.
When to see a doctor
Immediately consult a child to the doctor if he has symptoms of cryptorchidism as mentioned above. Treatment needs to be done immediately if the testicles do not descend until the child is 6 months old. This is necessary to prevent complications.
Check your baby regularly to the doctor, especially if the baby is born prematurely, has a low birth weight, or suffers from certain diseases. Checks are recommended at 3–5 days after birth, then regularly at 1, 2, 4, 6, 9, and 12 months of age.
Cryptorchidism diagnosis
To diagnose cryptorchidism, the doctor will ask about the symptoms experienced by the patient, as well as the medical history of the patient and his family. After that, the doctor will carry out a physical examination by looking at and feeling the scrotum and testicle area.
In some cases, the above steps are sufficient to diagnose cryptorchidism. However, in several other cases, the testicles may not be felt, so further examination is needed.
In addition, there are other conditions that are also similar to cryptorchidism, such as hydrocele and hernia . To confirm the diagnosis, the doctor will carry out supporting examinations with the following methods:
- Laparoscopy , which is a procedure by inserting a camera tube through a small incision in the baby's abdomen, to determine the location of the testicles in detail
- Scanning with ultrasound or MRI, to see a detailed picture of the testicles and to find out the position of the testicles
- Blood test , to determine hormone levels related to not descending or the absence of testicles in the scrotum
Cryptorchidism Treatment
Treatment of cryptorchidism aims to move the testicles to their normal position, namely in the scrotum. However, before the baby is 6 months old, the doctor will not do a special method, because in general the testes can still descend by themselves.
If after 6 months of age the testicles do not descend, the doctor will take further action. Treatment for cryptorchidism should be done when the baby is 6–18 months old to get the best results and prevent complications.
Methods of treating cryptorchidism that can be done by doctors include:
Orchidopexy
Orchidopexy is surgery to move or position the testes into the scrotum. This operation is performed by making an incision in the groin or stomach area, followed by the process of transferring the testicles to the scrotum.
If the position of the testicle is higher or reaches the abdominal area, the doctor will perform a laparoscopy to help move the testicle.
After surgery, the doctor will examine the scrotum, accompanied by regular ultrasound and hormone tests. This is done to ensure that the function and position of the testicles remain normal.
Hormone therapy
Hormone therapy is not always recommended. However, in some cases, the doctor may inject the hormone human chorionic gonadotropin (hCG) to stimulate the testicles to descend into the scrotum.
Cryptorchidism complications
If not handled properly, cryptorchidism can cause health problems, such as:
- Testicular cancer
- Infertility or infertility
- Inguinal hernia
- Stress due to an empty scrotum
- Testicular torsion
Cryptorchidism prevention
There are no specific measures to prevent cryptorchidism. However, there are several things that pregnant women can do to reduce the risk of this condition occurring in children, namely:
- Carry out routine pregnancy control , namely once every 1 month in the first and second trimesters, and once every 2 weeks in the third trimester
- Adopt a healthy lifestyle during pregnancy , such as consuming nutritious food, exercising diligently, and not smoking and not consuming alcoholic beverages
- Avoid contact with chemicals that are harmful during pregnancy, such as chemicals in paints and cleaning products
- Maintain and control health problems suffered during pregnancy, such as diabetes or obesity