Patient's question:
The testicle hasn't descended, the doctor said it's cryptorchidism; I want to ask, is this condition treatable? It's a newborn. Previous treatment history and effectiveness: The doctor said to treat again when one year old. What kind of assistance is desired: Directly seen in your column...Doctor's answer:
Hypospadias refers to a condition where one or both testicles fail to descend into the scrotum and remain at any point in their normal ascent process. In other words, there are no testicles in the scrotum or only one testicle is present on one side. Generally, as the fetus grows, the testicles begin to ascend from the retroperitoneal lumbar region during the later stages of fetal development and descend into the scrotum. If an obstruction occurs during this ascent process, it results in cryptorchidism.If parents notice that their child has no testicles in the scrotum or only one testicle on one side, they should seek medical attention immediately. For children under one year old, medication may be used to help the testicles descend into the scrotum. If the testicles still have not descended by the age of two, surgical intervention should be considered. Studies show that surgery before the age of two has minimal impact on the testicles' sperm production function. However, surgery before the age of four may cause significant interference, and before the age of eight, severe interference. Even if surgery is performed before the age of twelve, the testicles' sperm production function may not fully recover. Therefore, the surgical fixation of cryptorchidism should be performed before the age of two.
Survival care: Treatment methods
Children with cryptorchidism may have one or both testicles descend into the scrotum on their own within the first year of life. During this period, endocrine treatment can be used. For example, for a 10-month-old child, a luteinizing hormone-releasing hormone (LHRH) preparation, Crgptocur, 0.2 ng, can be administered three times daily. If the testicles still do not descend, human chorionic gonadotropin (HCG) can be used, with 1000 units administered twice weekly via intramuscular injection for four to five weeks. If the testicles have not descended by the age of two, surgical intervention should be performed, specifically testicular ascent fixation surgery. For adolescents with cryptorchidism, surgical fixation should be performed as soon as it is detected. If the testicles are found to be swollen or unable to descend into the scrotum during surgery, a testicular resection may be necessary.
Why is surgical treatment necessary for unilateral cryptorchidism?
In unilateral cryptorchidism, one testicle is present in the scrotum. Historically, it was believed that the testicle already in the scrotum had normal sperm production function and would not affect fertility. However, recent studies have shown that the testicle that has already descended may not develop normally. Studies indicate that only 40% of unilateral cryptorchid patients have normal sperm development, while the remaining 60% have issues, such as low sperm count, poor motility, or high rates of abnormal sperm. Additionally, the undescended testicle may develop into a malignancy in a high-temperature environment. Overall, it is clear that unilateral cryptorchid patients should also receive timely treatment. Even if fertility is not affected, early surgery is necessary to prevent the occurrence of testicular cancer.
The above advice addresses the question, "Can pediatric cryptorchidism heal on its own, and what is the best time for treatment?" I hope this is helpful to you. Wishing you good health!