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Thursday, July 24, 2014
Urinary and Genital Disorders (Children)
My Child`s Retractile/Undescended Testicle?
My son was born on the 20th of April, 2007, so he`s a 1 1/2 yrs old now. The day he was born we where told that he`s got an undescended testicle and it might descend in due time. During our regular monthly checkup on the 2nd or 3rd month after birth, his pediatric checked the scrotum or sag and told us that they(testicles) are both there and normal. So we thought that its back to normal as we where informed by the previous doctor who checked my son after birth immediately. But as time passed we realised that the scrotum was not well exposed so we again our child`s pediatric to check which was a month ago, and he said that yes it might be the case of a retractile testicle. But at the same time he directed us to a local Pediatric urologist and he said that the my child might need a surgery to descend his testicle but that will only be confirmed after he examines again in a 6wks. The fact that we live in the Middle East travelling to the U.S with a child would be very difficult; therefore I would really appreciate your reference for the best/top pediatric urologist/s in Europe(either England, Germany, France etc..) that you know off and trust for such cases? Thank you. Awaiting your early Feedback.
I hesitate to name the "best" pediatric center, as many are excellent throughout the world. In Europe, Great Ormand Street Hospital in London has an excellent reputation. I agree that the recommendation to be seen again in 6 weeks seems unreasonable, given your specific situation. In my experience, when the testis is undescended at birth, approximately 50% to 60% of the time it descends over the first 2 to 3 months. However, it is not unusual for it to "ascend", i.e., become undescended, again. The fact that your son is less that 2 years old and that the exam is uncertain suggests to me that the testicle is quite likely to become undescended over time and require surgery to reposition it in the scrotum. Consequently, to me it would be appropriate to plan to travel to a pediatric urology center with a tentative plan to have him undergo an orchiopexy (the surgical procedure that brings the testis into the scrotum). The operation has a 98%-99% likelihood of success.
Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University