Patient's question:
My son is 10 years old. He had a hernia when he was young, but it wasn't serious and he never had surgery. Recently, he had a check-up, and the doctor said his testicles were too small and underdeveloped. Could you please tell me how to confirm the diagnosis and whether it can be treated? Is it necessary to get checked immediately?Doctor's answer:
The testes are important organs in males, serving as the male gonads. They are located in the scrotum, with one on each side. After reaching adulthood, each testis is approximately 4–5 cm long, 3 cm wide, and about 2.5 cm thick, with a volume of 20–30 milliliters. The testes are divided into 200–300 seminiferous tubules, each containing three to four tubules where sperm are produced. These tubules merge to form the rete testis, from which 10–15 efferent ductules branch out, exit the testes, and eventually merge into a single duct that leads to the epididymis.The testes have two primary functions: one is to produce sperm, enabling male fertility, and the other is to secrete male hormones (androgens). These hormones act on the brain through the bloodstream, stimulating sexual desire and maintaining male secondary sexual characteristics. However, due to genetic disorders, nutritional factors, and other conditions, the size of the testes can vary from person to person. Some may be larger, while others may be smaller, but as long as they fall within the normal range, slight variations do not indicate the strength of sexual function or fertility. It is not accurate to judge sexual function or fertility solely based on testicular size—larger does not necessarily mean stronger function, and smaller does not necessarily mean weaker function.
However, there is a lower limit: if the testicular volume is less than 10 milliliters, it may indicate testicular hypoplasia or atrophy. In such cases, sperm production is significantly affected. Testes with a volume smaller than 10 milliliters often fail to produce sperm in the seminal fluid, leading to congenital azoospermia (no sperm) or severe oligozoospermia (low sperm count) or asthenozoospermia (low sperm motility). If both testes are smaller than 6 milliliters, the Leydig cells, which produce male hormones, may also be affected. This not only impairs sperm production but can also disrupt hormone secretion, impacting sexual function.
The main causes of testicular hypoplasia include the following:
1. Endocrine disorders: Abnormalities in the endocrine system, such as hypogonadotropic hypogonadism (a condition where the body fails to produce adequate reproductive hormones) or pituitary microadenomas, can affect testicular development, leading to hypoplasia.
2. Genetic factors: Chromosomal abnormalities, such as Klinefelter syndrome (a condition characterized by small testes or underdeveloped seminiferous tubules), can cause testicular hypoplasia.
3. Anatomical factors: In some cases, testicular hypoplasia may result from impaired blood supply during embryonic development or torsion of the spermatic cord during descent.
4. Infectious factors: The most severe case is orchitis caused by mumps during childhood, which can lead to testicular developmental disorders.
5. Trauma or surgical trauma: Some individuals may experience testicular damage due to injuries or surgeries, either in childhood or during puberty, leading to hypoplasia or atrophy.
These five factors are the primary causes of testicular hypoplasia.
When it comes to treatment, some cases of testicular hypoplasia may still have therapeutic potential if the age is not too advanced or the condition is not too severe. According to traditional Chinese medicine theory, the kidneys govern the storage of essence, reproduction, and development. By replenishing kidney essence and boosting kidney Qi, treatment can be beneficial. However, timing is crucial. If the individual is already an adult, the therapeutic value may diminish.
This highlights the importance of early detection and treatment for such conditions. If mumps occurs, prompt treatment can help control the infection. If testicular dysfunction is detected in childhood, parents should seek medical attention and work closely with doctors to address the physiological defects through treatment. This can still be meaningful. Therefore, testicular hypoplasia should not be ignored until adulthood, when marriage and family responsibilities arise—by then, it may be too late.
If your child is still young, it is essential to seek treatment as soon as possible to avoid delaying the condition. Wishing you a speedy recovery!