For many parents who have a baby boy, I guess the most fearful situation is that the baby is obviously with the handle, why is there no “balls”? Then where are the “balls”?
The importance of the testicles in the scrotum has been recognized in ancient times, and as modern people, we can have a more scientific understanding of the descent of the testicles. Sex differentiation in humans begins at 7-8 weeks of embryonic life, and as sex differentiation occurs, the testes gradually approach the inguinal canal that forms later and the gonads are supported and fixed at both ends, completing their migration to the scrotum late in gestation, about 35 weeks before testicular priming, a process that takes place under androgenic control. With this initial understanding of testicular descent, it is important to understand that the “balls” can appear anywhere on the descent path.
Definition of cryptorchidism: In the absence of tension in the spermatic cord, the testicle cannot be pulled into the bottom of the scrotum. According to the location, we can classify cryptorchidism as a testicle that stays on the normal descent path and an ectopic testicle.
Complications of cryptorchidism.
1. persistent damage to the descending incomplete testis due to high temperature in the scrotum which is 4 degrees lower than the body temperature.
2. dysfunction of the testicular supporting cells and the amount of testosterone may be affected.
3. damage to testicular interstitial cells occurs at 2-6 months, and 40% of germ cells are lost in patients with cryptorchidism at 2 years of age, affecting fertility
4. unilateral testicular malignancy is 15 times higher than normal and bilateral up to 33 times higher, especially the risk of ventral sex is higher
5. inguinal hernia, cryptorchid torsion, abnormal fusion of testis and epididymis, etc.
Cryptorchidism diagnosis.
The diagnosis of cryptorchidism is not difficult, and currently with the help of ultrasound and other imaging tests can accurately locate cryptorchidism; however, attention should be paid to differentiate it from normal retractile testis, which is characterized by the following performance features.
1. the testis is dragged into the bottom of the scrotum without difficulty
2. it can be maintained in the scrotum for a period of time without immediate retraction
3, the testicle is of normal size.
4. A history of spontaneous descent of the testicles into the scrotum.
How to get the “balls” back into the scrotum?
1.Hormone therapy: the effect is poor unilaterally, and the effect is about 14%-25% bilaterally, but currently hormone therapy is not supported by most experts.
2.Surgical treatment.
Complications of surgery.
1.Inability of the testicle to descend into the scrotum.
2, testicular atrophy.
3.retraction of the testis.
4, obstruction of the vas deferens.
5, bleeding.
6.Wound infection.
However, there is no definite conclusion about the long-term observation on fertility after testicular descent fixation. In any case, it is recommended that small children without balls should undergo early surgical treatment.