Testise undescended testicles in the first year of life

Early therapy of undescended testes lowers the risk of sterility and testicular cancer

06/03/2014

If an undescended testicle is diagnosed in a newborn boy, this should already be treated medically during the first year of life. This recommendation is based on a new guideline of the German Society for Pediatric Surgery (DGKCH). Accordingly, it is urgently to discourage longer waiting, as this may lead to a reduction in fertility or even inability to conceive. The risk of testicular cancer can also be reduced by early treatment, the DGKCH experts report.

Most common congenital malformation of the urinary and sexual apparatus
Is a so-called „Undescended testicles“ (Maldescensus testis), one or both testicles are not found in the scrotum of a newborn after birth, but in most cases in the inguinal canal or in the abdominal cavity. Testicular uptake is the most common congenital malformation of the urinary and genital apparatus affecting just one to three percent of mature and even up to 30% of premature baby male babies. The congenital deviation usually requires treatment, as the testicular tissue is damaged by a permanent abnormal situation over time and threaten serious consequences such as infertility or testicular cancer.

In only 7 percent of cases, no therapy is needed
Accordingly, according to the German Society for Pediatric Surgery, the treatment of undescended testicles should start as early as possible in order to avoid long-term damage. In about seven percent of cases, however, the testes take their normal position in the scrotum after birth even without therapy. Since no complaints usually arise during this time, according to the DGKCH experts, the first half of the year should first be awaited - if nothing happens during this time, an improvement in the situation will become increasingly unlikely: „Unlike in the past, where surgery was often performed years later, it is believed today that the testis should be placed in the scrotum until the first birthday“, explains Barbara Ludwikowski, Head of the Department of Pediatric Surgery at Bult, Hanover. The high stand is usually there „open“ operated, which would be successful in 74 to 96 percent of cases. Before the operation, the small patients could also be treated with hormones, which, however, will be critically considered by many experts: „However, the use of hormones is controversial, as the long-term effects of an impact on the child's hormonal balance are not yet fully understood“, so Dr. Ludwikowski continues.

Great shame and mental impairment due to damage to the genitals
The possible damage in the genital area should not be underestimated:„An imperfect or incomplete genital can cause great shame and emotional distress“, Barbara Ludwikowski continues. In addition, the risk of cancer can be significantly reduced by early detection. An important aspect - because as the scientist explains, men who as a child have one „Maldeszenus testis“ an up to 10-fold increased testicular cancer risk. „This danger is not banned by the operation“, so the Barbara Ludwikowski, „however, it is lower the earlier the testes are in the scrotum.“ According to the DGKCH, testicular cancer is the most common type of cancer in men between the ages of 20 and 45 years, with around 4,000 new cases every year in this country.

Collaboration of parents urgently needed
Accordingly, according to DGKCH President Bernd Tillig, the new guideline would pursue the goal, „[...] to complete the treatment until the age of 12 months“, because then you could expect the best results. In order to be able to act in time, however, the attention of the parents is indispensable, because they would have to watch their child closely and if suspected undescended testicles immediately go to a pediatrician. (No)