Soon after the birth of a male child, both the testes
can be felt lying inside the scrotum. Sometimes, the scrotum may
appear ‘empty’ on one or both sides. The reason could be varied.
In the foetus, the testes lie inside the abdomen. They come down just before the expected
time of delivery. If
the baby is born before the expected time, it may take some time before we can feel the testes.
Some testes are called ‘shy’ testes or ‘retractile’
testes. These are normally present in the scrotum but as soon as the scrotum is touched, especially with cold hands, the
testes tend to go up into the abdomen, making the
scrotum appear empty. Such a testicle does not need any
treatment. This child will have a normally functioning testicle.
If one or both testes are really missing from the
scrotum, we wait until the child is 1 year old. If after that, it
cannot be felt on one or both sides, it is advisable to see a
surgeon, preferably a paediatric surgeon. If the surgeon is
convinced that it is undescended, surgery will be advised to bring
it down and to fix it into the scrotum. Although some
surgeons believe in postponing the surgery till the age of 2 or 3
years, paediatric surgeon Dr. Jyotsna Kirtane believes it
advisable to operate at 6 months, because electron microscope studies have
revealed that the undescended testis may undergo degenerative changes after 6 months.
If both the testes are not felt, and the clinical
examination reveals some doubt, the doctor may ask for a test to determine the sex of the child.
There are two possible risks involved in leaving the testes inside the abdomen. The first is
degeneration and infertility, and the other is the development of cancer
of the testes.
Here a passing reference may be made about uneven testes in an adolescent. Assure your
teenage that it is quite
normal for one testis to be lower than the other.
Children with undescended testes may have an associated hernia, which is seen as a
swelling coming up in the
groin whenever the child cries or strains. In such cases, it
is advisable to operate on the undescended testis as early
as possible, because hernia in a small infant tends to get obstructed.
