|Discussion in 'All Categories' started by MOHAMMED UNUS BASHA - Aug 13th, 2014 11:44 am.|
MOHAMMED UNUS BASHA
|My sister's only son Mohammed Tanveer Hussain aged about 11 years is suffering with Bilateral undescended testis both in proximal inguinal region for which surgery(Orchidopexy) for both the testis is prescribed by Dr.K.V.Ravi Kumar, Pediatric Surgeon, Manipal Hospital, Vijayawada, Andhra Pradesh. Besides, I have taken the second opinion from other pediatric Surgeon,Dr.Rajinikanth, who preferred surgery in two stages with intermittent 6 months gap for each testis. There is a difference of opinion and they are suggesting for open surgery. Besides, they are mentioning of risk factor of reduced fertility, urological problems, strive for optimization of spermatogenesis and chance of testical cancer etc. We are not able to decide what is the best course of action to safeguard the boy health. Please render your kind suggestion.|
re: Bilateral undescended testis both in proximal inguinal region by Dr.J S Chowhan - Aug 14th, 2014 11:05 am
Dr.J S Chowhan
|Dear Mohammed Unus Basha
In undescended testis goal of treatment is to move the undescended testicle to its proper location in the scrotum before 1 year of age. It might lower the risk of complications of an undescended testicle, such as infertility and testicular cancer.
Complications of a testicle not being located where it is supposed to be include:
Fertility problems. Low sperm counts, poor sperm quality and decreased fertility are more likely to occur among men who've had an undescended testicle. A decrease in cells in the testicle that produce sperm has been found as early as 1 year old.
Other complications related to the abnormal location of the undescended testicle include:
Testicular torsion. Testicular torsion is the twisting of the spermatic cord, which contains blood vessels, nerves and the tube that carries semen from the testicle to the penis. This painful condition cuts off blood to the testicle. If not treated promptly, it might result in the loss of the testicle. Testicular torsion occurs 10 times more often in undescended testicles than in normal testicles.
Trauma. If a testicle is located in the groin, it might be damaged from pressure against the pubic bone.
Inguinal hernia. If the opening between the abdomen and the inguinal canal is too loose, a portion of the intestines can push into the groin.
The early surgery is better and both open and laparoscopy surgery will be required to lengthen the cord structures and fixing the testis in the scrotum. The scrotum will be underdeveloped in this boy and the surgeon will also have to create a dartos pouch to house the testis.
Dr J S Chowhan
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