Ask the Doctor: ‘What does the procedure to rectify an undescended testicle involve?’
All your burning health questions answered by the professionals.
“My son was born with an undescended testicle. He is now three months old and this has still not rectified itself like the doctor thought it probably would. My question, what does the procedure to fix this involve, and is it dangerous for my baby? Should we wait until he is a few years old before considering surgery?”
Answer from Fardod O’Kelly MD MBA FFSEM FEBU FRCS (Urol), Consultant Paediatric & Adolescent Urological Surgeon, Beacon Hospital
This is a really important question and the first thing to note is that having a testicle outside of the scrotum is very common and affects approximately 1/30 boys at birth. Many of these will come down by themselves as boys tend to produce extra testosterone naturally between three to six months of age, and therefore by about six months of age, this condition tends to affect 1/100 boys. This doesn’t seem that common, but on a population level in Ireland, it results in about 250-300 new cases per year that need to be dealt with.
The most important thing is to make sure that if your son still has this issue by six months of age, then he needs to be seen by a paediatric urologist who will be able to counsel you as to whether an operation is required or not. These operations used to be performed at a much older age, but with international research, the window for operating is now between six to 18 months of age in order to achieve the best possible outcomes in terms of reproductive potential and to reduce the risk of testicular cancer later in life.
The operation is very safe and considered to be low-risk (not no-risk) and is not considered dangerous at all. In general, for a planned operation like this, it is preferable to do this from 12 months of age to reduce the risk of any anaesthetic complications which exist below this age.
Therefore, we would often try to have a narrow window of 12-18 months of age to operate. It would involve a general anaesthetic for about 25 minutes, and the operation takes about 20 minutes. It can usually be done through a minimally invasive approach with a single small incision in the scrotum and is a day case which means your son would go home a couple of hours after the procedure. It involves freeing up the testis and placing it into a pocket within the scrotum. The risks are in general very low with blood loss only being a couple of drops, however, your paediatric urologist would go through these in more detail before planning the procedure.
It is really critical not to leave these cases sitting around and waiting. Your son needs to be assessed, ideally before turning one, and if an operation is required, it should be planned within the internationally recommended window of below 18 months of age.
Have a question for the professionals you’d like answered? Get in touch with sarah.gill@image.ie with the subject headline ‘Ask The Doctor’.
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