Testicular Issues in Infants: A Parent's Guide

Q: Testicular Issues in Infants: A Parent's Guide

Emily： Hello, it is uncommon for babies at this age to experience such symptoms. <br>I believe it could be due to testicular torsion leading to testicular necrosis. <br>This means that the testicle twisted for an unknown reason, causing severe pain and crying. <br>However, due to

Infant testicles

Hello Doctor, my baby was just born 25 days ago.
On the 25th day, he cried for more than an hour, and I discovered that his right testicle was swollen.
I immediately took him to the hospital, where the doctor diagnosed him with a hernia.
However, during the surgery, it was found that the right testicle had already died.
The doctor mentioned it was congenital and that it might have twisted during the descent process, leading to necrosis.
I would like to ask the doctor:
1.
When the baby was born, the appearance of the scrotum and testicles seemed normal.
Is it possible that the testicle was already dead at that time? Would it not cause any pain?
2.
The surgeon said that the testicle was not related to the hernia this time.
Could this really not be due to a delay in seeking medical attention? Has this situation been seen clinically before? Is there truly no explanation for the cause?
3.
If the right testicle has atrophied and died, but the left side is normal, will his future fertility and sexual function be normal?
4.
Since this is my first child and such an event has occurred, I am very worried and feel helpless.
I hope the doctor can patiently answer my questions.
I am very grateful.

Emily, 0~9 year old female. Ask Date: 2008/05/10

Dr. Xu Weikai reply Urology

Emily: Hello, it is uncommon for babies at this age to experience such symptoms.
I believe it could be due to testicular torsion leading to testicular necrosis.
This means that the testicle twisted for an unknown reason, causing severe pain and crying.
However, due to the way the child expresses discomfort and the inexperience of first-time parents, they may not be able to make the correct judgment immediately.
By the time the scrotum starts to swell, some time has already passed since the onset of the condition, and the testicle has likely already undergone necrosis.
Here are brief answers to your concerns:
1.
At birth, medical facilities typically conduct preliminary examinations, and if any issues arise, they will refer to relevant specialists for diagnosis.
The chance of necrosis occurring at that time is almost impossible because testicular torsion is extremely painful.
Note: Testicular torsion usually occurs in adolescent males and is rare in other age groups.
When it occurs in such young infants, it may be related to congenital developmental discrepancies in the internal structures of the scrotum.
2.
Hernias generally do not affect the testicles and rarely lead to necrosis.
3.
Fertility and sexual function can generally be normal as long as one testicle is functioning properly.
However, sometimes testicular necrosis can lead to the production of abnormal antibodies in the body, which may affect future sperm development.
Of course, this latter occurrence is rare, but it is worth mentioning to give you an understanding.
If you are interested, you can look up "anti-sperm antibodies" online.
If there are any unclear points, feel free to ask again, and we can discuss and research further together.
Sincerely,
Director of Urology,
Taitung Hospital,
Department of Health, Executive Yuan,
Hsu Wei-Kai

Reply Date: 2008/05/10

More Info

I'm sorry to hear about the challenges you're facing with your newborn. It's understandable to have concerns when it comes to your child's health, especially regarding such sensitive issues as testicular problems. Let's address your questions one by one.

1. Could the testicle have been dead at birth?
It's possible for a testicle to be nonviable at birth without any visible signs. In some cases, a testicle may have undergone torsion (twisting) during the descent process, which can lead to reduced blood flow and subsequent necrosis (death of tissue). However, this condition typically presents with pain or swelling. If the testicle was indeed nonviable from birth, it may not have caused immediate pain, which can make it difficult to detect. The absence of pain does not necessarily mean that the testicle was healthy; it could have been compromised without showing overt symptoms.

2. Is there a connection between the hernia and the testicular issue?
In many cases, inguinal hernias can be associated with testicular issues, particularly in infants. However, the surgeon's assessment that the hernia and the testicular necrosis are unrelated is not uncommon. Testicular torsion can occur independently of hernias, and while both conditions can arise from similar anatomical predispositions, they do not always influence each other directly. Delayed medical attention can sometimes exacerbate conditions, but in your case, the surgeon's findings suggest that the necrosis was likely due to an underlying congenital issue rather than a direct result of delayed treatment.

3. What does the loss of one testicle mean for future fertility and sexual function?
The loss of one testicle does not necessarily mean that your child will have compromised fertility or sexual function in the future. The remaining testicle can often compensate for the loss, producing sufficient testosterone and sperm. Many men with one testicle lead normal, healthy lives, including having children. However, it's essential to monitor your child's development and consult with a pediatric urologist or endocrinologist for ongoing assessments.

4. Concerns as a first-time parent:
It's completely natural to feel anxious as a first-time parent, especially when faced with unexpected medical issues. The best course of action is to maintain open communication with your child's healthcare providers. They can provide you with the necessary information and support as your child grows. Regular follow-ups will help ensure that any potential issues are addressed early on.

In summary, while the situation is undoubtedly concerning, many children with similar conditions go on to lead healthy lives. It's crucial to stay informed and proactive about your child's health, and don't hesitate to seek support from healthcare professionals. They can guide you through this process and help alleviate your worries. Remember, you're not alone in this, and many parents face similar challenges.

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