The impact of a bulging crest on a child cannot be underestimated, so when is the best time to operate? How will the child recover after surgery, and will he or she be able to grow and play like a normal child? First of all, let’s take a look at when cremasteropathies are formed. In fact, the development of the neurological spinal canal begins during the embryonic period. Normally, the neural canal closes when the baby is about 3 weeks in the mother’s tummy. A prenatal checkup at this time can tell whether the child’s neural tube is closed properly, and early intervention can be made for fetuses with problems. If no intervention is done, problems such as cremasteric cleft and cremasteric bulge will gradually develop during the embryonic period as the embryo grows. (As shown in the picture) Since cremasteric bulge develops during the embryonic period, do the symptoms appear immediately when the child is born? In fact, although cremasteric bulge forms during the fetal period, most children do not develop symptoms anytime soon after birth. It is only during the growth and development process that the crestal pulp and crestal membrane of the child with cremasteric bulge expand from the crestal fissure and are connected to the bulge (i.e., cremasteric embolus), and the growth rate of the cremaster is slower than the growth rate of the cremaster, so the cremaster in patients with cremasteric embolus will gradually elongate. In addition, the crestal medulla does not grow in its normal position during embryonic development (i.e., the crestal cone is low), and this stretching affects the function of the crestal medulla and results in symptoms. This is especially true for the cremaster of the lumbosacral segment, which is primarily responsible for urination and defecation and the motor and sensory functions of the lower extremities. If the cremaster bulges there, the child will gradually develop symptoms such as urinary and fecal dysfunction, lower limb movement disorders or deformities, and a “small tail” in the back. These symptoms may worsen as the child grows older. Therefore, after the birth of such a child, regardless of whether or not there are obvious symptoms, it is necessary to actively examine, evaluate and treat the child, and generally after the first month of life, prompt surgery. Cricoid membrane bulge surgery is to return the bulging cremaster and cremaster membrane to their normal position and repair the cremaster membrane; if the child also has lipoma and cremaster embolism, the surgery should also remove the lipoma and loosen the embolism as much as possible. However, it is heartbreaking for parents to see their child on the operating table at such a young age. If the child does not have any discomfort yet, and there is no obvious lump or “tail” like bulge on the back, it is not too late to operate when the child grows up a bit, or when symptoms appear. If surgery is performed before symptoms appear, timely retraction of the bulging cremaster, repair of the cremaster fissure, and release of the embolism can prevent damage to the cremaster and achieve better results, and even be able to learn and play like ordinary children. If the child grows up or even develops symptoms before surgery, then the damage to the cremaster function is already more serious, and the cremaster bulge surgery alone can only prevent the condition from worsening, but cannot repair the damaged cremaster. In addition to the opportunity to influence the outcome of surgery, the main factors affecting the outcome include the preoperative cremaster, the degree of cremaster distention, and the location of the cremaster cone. Of course, a good postoperative nutritional supply and adequate functional exercise are also important for the child’s recovery. The more severe the degree of preoperative cremasteric bulge or the low position of the cremasteric cone, the more severe the degree of impairment of cremasteric function will be, and the postoperative recovery will be less satisfactory. For example, if there is only a simple crural bulge and the cremaster grows in a normal position, the postoperative recovery will be more satisfactory if the cremaster is repaired in time by surgery, the embolus is released, and the normal height of the cremaster cone is maintained. In contrast, for patients with cremaster crestal bulge, if there are very many bulges, or even adhesions between cremaster and cremaster, and the position of cremaster cone is too low, the postoperative recovery is not good. Moreover, for children with combined lipomas, the lipomas are also removed during the surgery. Although lipomas are generally difficult to remove cleanly and can easily recur, the residual lipoma will not affect the postoperative result too much.