Cryptorchidism in Infants: When to Consider Surgery?

Cryptorchidism in children

Hello Dr.
Pei,
I would like to ask you a question.
When my child was born, the doctor mentioned that one of his testicles had not descended and was still in his abdomen.
They said it might descend on its own as he grows older.
Now my child is almost 11 months old, but that testicle is still hidden in his abdomen.
We have consulted different pediatricians; some recommend immediate surgery, while others suggest waiting until he is two years old to reassess.
I naturally prefer not to have him undergo surgery at such a young age due to the risks associated with anesthesia, but some doctors advise that it is better to address this before he turns one.
I am feeling quite confused and would like to ask for your advice on how to proceed.
Thank you very much.

Xiao Fen, 30~39 year old female. Ask Date: 2011/06/06

Dr. Pei Rensheng reply Pediatrics

Dear Xiao Fen,
Hello!
1.
If a child is diagnosed with cryptorchidism and remains undescended by the age of 6 months, treatment is recommended.

2.
Hormonal therapy or surgical intervention can be considered, and I suggest you consult a urologist.
Currently, surgical treatment is the primary approach.
Wishing you health and happiness!
Sincerely,
Dr.
Pei Ren-Sheng
Director of Pediatrics, Taoyuan Hospital, Department of Health

Reply Date: 2011/06/06

More Info

Cryptorchidism, or undescended testis, is a condition where one or both testicles fail to descend into the scrotum before birth. This is a common condition in newborns, and while many cases resolve spontaneously within the first year of life, some require surgical intervention. The timing of surgery for cryptorchidism is a topic of considerable debate among pediatricians and pediatric urologists.

In your case, your child is now nearly 11 months old, and the undescended testis has not yet descended. The general consensus among medical professionals is that if a testicle has not descended by 6 months of age, it is unlikely to do so on its own. The recommended timeframe for surgical intervention is typically between 6 months and 18 months of age. This is because the risk of complications, such as infertility and testicular cancer, increases if the condition is left untreated beyond this window.

Surgery, known as orchidopexy, is usually performed under general anesthesia. While the risks associated with anesthesia are a valid concern, the benefits of timely intervention often outweigh these risks. If surgery is delayed until after the age of 2, there is a higher likelihood that the testicle may not develop properly, which can lead to long-term complications.

In your situation, it is essential to consider the opinions of the various pediatricians you have consulted. If some recommend immediate surgery while others suggest waiting, it may be beneficial to seek a second opinion from a pediatric urologist who specializes in this condition. They can provide a thorough evaluation and discuss the potential risks and benefits of surgery versus observation.

In addition to the physical aspects of cryptorchidism, it is also important to consider the psychological impact on your child as he grows older. If the testicle remains undescended, it may lead to feelings of embarrassment or self-consciousness in the future. Early intervention can help mitigate these concerns.

Furthermore, it is essential to monitor for any signs of complications, such as pain or swelling in the groin area, which could indicate a more serious issue. Regular follow-ups with your pediatrician or urologist can help ensure that any changes in your child's condition are addressed promptly.

In summary, while the decision to proceed with surgery for cryptorchidism can be challenging, the general recommendation is to consider surgical intervention before the age of 18 months. Consulting with a pediatric urologist can provide clarity and help you make an informed decision that prioritizes your child's health and well-being. Remember that timely treatment can prevent potential complications and promote normal development.

Similar Q&A

Understanding Cryptorchidism in Infants: When to Consider Surgery

Hello Doctor: On November 22, I took my baby to the hospital for vaccinations. During the pediatric check-up, I asked the doctor to examine my son's genitalia because I recently noticed that one of his testicles seemed to be missing. The doctor diagnosed it as cryptorchidism...

Dr. Zhao Yongkang reply Pediatrics
Dear Concerned Mother, 1. Generally, the recommended timing for surgery for cryptorchidism is when the child is about 9 to 15 months old. However, based on your description, if your child can feel the testicle during bathing, it may be a case of retractile testis. In this situat...

Understanding Cryptorchidism: Concerns and Next Steps for Your Child

My younger brother underwent surgery to remove a testicle, but after a few days, it was reported that it was missing again. The doctor mentioned it was a case of retractile testis, but now that he is almost two years old and it hasn't descended, we are concerned about its im...

Dr. Lin Yishou reply Pediatrics
Please quickly consult a pediatrician or a pediatric surgeon to recheck the position of the testicles.

Understanding Testicular Absence in Infants: Surgical Options and Outcomes

My son is currently one year old, and there are no testicles in his scrotum. After a hospital examination, they said, "It's not cryptorchidism; they are located nearby and can be surgically moved to the correct position." They also mentioned that surgery is not nec...

Dr. Li Xinyi reply Urology
It sounds like there shouldn't be any issues. As long as the testicles are not in the abdominal cavity and can develop normally, there is a chance for gradual improvement. However, it is still important to see a urologist for a thorough examination to confirm the diagnosis a...

Understanding Anorchism: Symptoms and Insights on This Urological Condition

Please provide information related to anorchism, such as its symptoms.

Dr. Liu Jianting reply Urology
It is likely cryptorchidism! Every newborn male should be checked for the presence of "two testicles." Generally, most full-term infants have their testicles descend from the retroperitoneal cavity into the scrotum. If a pediatrician discovers that one or both testicles...