Post-Testicular Rupture Care: Monitoring and Fertility Concerns in Boys

Q: Post-Testicular Rupture Care: Monitoring and Fertility Concerns in Boys

Hello： In your situation, if you are able to ejaculate, a hospital can test your sperm count. <br>If the sperm quality is adequate, there is no need to worry too much, although the possibility of infertility still exists. <br>If the sperm count is low or the motility is poor, inf

Testicular rupture

Doctor, if a child has sustained an injury resulting in the rupture of one testicle and has undergone unilateral orchiectomy, how long should we wait before scheduling a follow-up appointment with a urologist? What specific tests should we monitor on the remaining testicle to assess its function? At what age do boys typically begin to produce sperm? Should we consider sperm banking for the child in advance? I am concerned that he may want to have children in the future but might be unable to do so.
Thank you, doctor!

Niming, 10~19 year old female. Ask Date: 2020/03/26

Dr. Du Shixi reply Urology

Hello: In your situation, if you are able to ejaculate, a hospital can test your sperm count.
If the sperm quality is adequate, there is no need to worry too much, although the possibility of infertility still exists.
If the sperm count is low or the motility is poor, infertility is quite likely.
To prevent infertility, sperm preservation is one option; however, it is not inexpensive.
Additionally, when you are married and wish to conceive, it is important to have viable sperm at the time of ejaculation.
You may also consider artificial insemination.
You can proceed with artificial insemination when you are ready to conceive after marriage.
By then, reproductive technology will likely be more advanced.
Wishing you good health.

Reply Date: 2020/03/26

More Info

In the case of a boy who has undergone a unilateral orchiectomy (removal of one testicle) due to a testicular rupture, ongoing monitoring and care are crucial for his overall health and future fertility. Here’s a comprehensive overview addressing your concerns:

Follow-Up Care and Monitoring
After the removal of one testicle, it is generally recommended that the child have follow-up appointments with a urologist. The frequency of these visits can vary based on the individual case, but typically, it is advisable to have an initial follow-up within 3 to 6 months post-surgery. After that, annual check-ups may suffice, unless there are specific concerns or symptoms that arise. During these visits, the urologist will assess the remaining testicle's size, consistency, and any potential issues.

Assessing the Function of the Remaining Testicle
To evaluate the function of the remaining testicle, several key assessments can be performed:
1. Physical Examination: The urologist will conduct a thorough physical examination to check for any abnormalities in the remaining testicle.

2. Hormonal Assessment: Blood tests can measure testosterone levels and other hormones to ensure that the testicle is functioning properly. Testosterone production is crucial for puberty and overall male health.

3. Ultrasound: A scrotal ultrasound may be performed to visualize the remaining testicle and check for any structural abnormalities or issues.

4. Semen Analysis: Once the boy reaches puberty, a semen analysis can be conducted to evaluate sperm production and quality. This is typically done around the age of 13 to 15, when boys begin to produce sperm.

Age of Sperm Production
Boys typically begin to produce sperm during puberty, which can start as early as age 9 and as late as age 14. The average age for the onset of sperm production is around 12 to 13 years. However, the exact timing can vary significantly among individuals.

Sperm Preservation Concerns
Regarding sperm preservation, it is understandable to be concerned about future fertility, especially after a significant medical event like a testicular rupture. If the remaining testicle is functioning well, the boy may have a good chance of fathering children later in life. However, if there are concerns about sperm production or quality, sperm banking (cryopreservation) can be considered.

Sperm banking is typically recommended for boys who are approaching puberty and may have concerns about their fertility due to medical conditions or treatments. In this case, it would be prudent to discuss the option of sperm banking with a fertility specialist or urologist when the boy reaches an appropriate age, usually around 12 to 14 years old.

Conclusion
In summary, after a unilateral orchiectomy, regular follow-up with a urologist is essential to monitor the health and function of the remaining testicle. Hormonal assessments, physical examinations, and eventually semen analyses will provide insights into fertility potential. While sperm production typically begins during puberty, proactive discussions about sperm banking can help alleviate concerns about future fertility. It is crucial to maintain open communication with healthcare providers to ensure the best outcomes for the child's health and reproductive future.

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