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Undescended Testes In Children

The male sexual glands are the testes, and they produce sperm and hormones for sexual reproduction. The testes typically reside in the scrotum, occasionally one or both testes may not descend into the scrotum after developing, which means that when the testis is outside its normal location in the scrotal sac, it is called an undescended testis. This condition normally occurs before birth.

What causes a child to have undescended testes?

Early-born infants are more likely to have undescended testes (preterm or premature babies). This is due to the fact that the testes do not descend into the scrotal sac until month 7 of a baby’s development in the uterus. Other factors contributing to undescended testes could be spina bifida or hormonal issues.

Testicles may shift up and down from the scrotum back into the groin as a reflex, which could be the root of the problem (retractile testes). The testicles can sometimes be absent. Rarely, a child who has had an inguinal hernia repaired may experience undescended testes.

Which children are most likely to have undescended testes?

An estimated 3 in 100 to 1 in 20 male infants are born with this disease.

A child is more vulnerable if:

Born before 37 weeks of pregnancy

Tiny for the gestational age

With low birth weight

Has a family member suffered from the condition

What are the different categories of undescended testes?

Congenital and acquired undescended testes are two different categories.

Congenitally undescended testes:

Congenitally undescended testes are present in newborns who are born without scrotal testes.

Most of the time, doctors are unable to identify the cause; however, some hormone and genetic problems can result in undescended testes.

The testes might not have had enough time to descend into the scrotum by the time premature babies are born.

Acquired undescended testes:

Sometimes a child’s testicles are in the scrotum when they are born, but they later grow undescended testes.

The spermatic cord stops expanding at the same rate that the kid does. It becomes too short in the end and forces the testis back into the groin.

Between the ages of one and ten, this can occur.

What signs would a child have of undescended testes?

Each youngster may exhibit somewhat different symptoms. The most typical symptom is when a doctor performing an examination cannot feel the testes. Most kids who have an undescended testicle don’t exhibit any symptoms.

How are children’s undescended testes identified?

The doctor will inquire about your child’s symptoms and medical background. He or she might also inquire about the medical history of your family. Every time your child receives a well-child checkup, the healthcare expert will look for testicles in the scrotum. To locate the testicles within the pelvis, imaging procedures like an MRI or an ultrasound may occasionally be required.

When to visit a doctor

Your maternal and child health nurse or your doctor will notice if your child has undescended testes shortly after birth. The health of your infant will be monitored.

Consult your doctor if one or both of your baby’s testicles disappear from the scrotum after they were present there at birth. You’ll be given a paediatrician or paediatric surgeon’s contact information to consult, as the testes must be brought all the way down to the scrotum.

There is a risk of ongoing health issues, as below, if the testes do not come down:

Torsion – It is possible for the spermatic cord to twist, which can stop the blood flow to the testes.

Inguinal Hernia – when a bowel loop enters the scrotum.

Reduced fertility – The production of sperm in the testes may be impacted by the fact that the body temperature in the abdomen is higher than in the scrotum.

Risk of testicular cancer This only occurs in a small percentage of boys. Typically, the risk is less than 1 in 100.

Poor self-esteem due to having genital features that are unusual.

How are children with undescended testes treated?

Your child’s symptoms, age, and overall health will all affect the course of treatment. Furthermore, it will depend on how serious the problem is. By the age of three months, the testes frequently fall into the scrotum on their own. The testicles often pass naturally by the time a child is 6 months old.

Other situations might call for treatment. This might comprise:

Surgery: Surgery may be used to transfer the undescended testicle into the scrotal sac. Orchiopexy is the name of this procedure. usually between the ages of 6 and 18 months. For most kids, it works.

Hormone treatment: The body may produce testosterone in response to some hormones. The testes are assisted in entering the scrotal sac by this. Only certain circumstances call for this treatment. Speak with your child’s medical professionals about the advantages, disadvantages, and potential adverse effects of each medication.

Find out what kind of treatment is recommended for your child by speaking with their healthcare professional.

Follow-up after the treatment of undescended testes

After the procedure, your child’s surgeon will schedule a visit with them. To ensure the testicle stays in the scrotum, routine inspections may be required. When they reach adolescence, your child will need to learn how to perform a routine testicular self-examination.

If you have any more questions about undescended testes, you are always welcome to get an appointment with Dr. Prashant Jain, one of the finest young and dynamic pediatric surgeon and pediatric urologist in Delhi.

TAGS -  pediatric surgeon in delhi, Pediatric Urologist In Delhi, Undescended Testes In Children, Undescended Testicles In Children

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Best Pediatric Surgeon in India

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Dr. Prashant Jain sounds is accomplished and dedicated pediatric surgeon and urologist. His training in esteemed institutes like King Edward Memorial Hospital in Mumbai and Kalawati Saran Children’s Hospital in New Delhi speaks volumes about his educational background. Being a gold medalist in both pediatric surgery and urology highlights his exceptional skills and commitment to excellence in these fields.

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Imperforate anus or absent anal opening, also called anorectal malformation, is a birth defect that happens during the development of baby in early in pregnancy, when the baby is still developing. In this defect, the baby’s anal opening (where stool exits) and the rectum (the last part of the large intestine), do not develop properly, preventing the child from to pass stool.

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Pediatric Surgery: Choosing Your Pediatric Surgeon

Introduction

For parents, children are the most valuable assets. They leave no stones unturned to provide them with necessities and facilities. They make no compromise to their child’s health and provide with them the best healthcare facilities. They search for the best pediatric doctor and pediatric surgeon in India to restore their child’s health.

When You Require A Pediatric Surgeon?

Various diseases in children require surgery. The pediatric surgeon performs surgery in children. The pediatric surgeon generally treats infants, neonatal and adolescent patients. General surgeons can perform surgery on both the child and the adults. However, pediatric surgeons are believed to have more skills while handling, listening, diagnosis, and treating a child patient. They are more experienced in handling the child both psychologically, physically, and emotionally.

What Is The Function Of Pediatric Surgeon?

Many children have congenital disorders. They are not able to live a healthy life until those disorders are effectively treated. Some of the diseases are even life-threatening. A pediatric surgeon is an expert in handling diseases, either congenital or acquired, in children. Following are the functions performed by the pediatric surgeon:

Diagnosis: Diagnosis of the disease is the first step towards treatment. With a proper diagnosis, the pediatrician would be able to start appropriate treatment.

Non-surgical treatment: After the diagnosis is done, the pediatric surgeon may prescribe certain medications that may either help reduce the symptoms or treat the disease or may reduce the symptoms and treat the condition.

Surgical Interventions: If the non-surgical interventions are not able to provide adequate relief, a pediatric surgeon may advise surgical interventions and also perform the surgery.

Post-operative care: After the surgery is completed, post-operative care and monitoring are also done by a pediatric surgeon.

What Are The Diseases In Which Surgery May Be Required In Children?

Diseases that require surgery in children are:

Abdominal Cyst: Abdominal cyst is a condition characterized by presence of abnormal mass inside the abdomen. In some cases, the cyst does not cause any problem. However, in other cases it may lead to complications. Although largely asymptomatic, obstruction in the abdomen, internal bleeding and pain may occur in some patients.

Hirschsprung disease: Hirschsprung disease is present in the child by birth. In this disease, the nerve cells in the large intestine are absent. The condition leads to functional obstruction in bowel movement.

Gallstones: Gallstones are formed due to supersaturation of bile. The most common form of gallstones present in children are pigment gallstones. The are found in children with hemolytic disorders. Also cholesterol stones are found quiet often.  Pigment gallstones, formed due to high concentration of bilirubin in bile, is a common type of gallstone in children.

Imperforate anus: In this condition, there is a defect in the opening of anus. The anal opening is either not formed or is blocked.

Biliary atresia: In this condition, the one or more bile ducts of the child are either absent, narrow or blocked. The condition may be present with birth or is acquired later in life. Liver failure may occur if biliary atresia is not adequately treated.

Choledochal cyst: Choledochal cyst is the dilation of one or more bile ducts. The condition is congenital i.e. present at the time of birth. The surgery done to remove the cyst is considered as definite treatment for this condition.

Merkel’s diverticulum: Merkel’s diverticulum is the condition in which there is growth of pouch in intestine. This condition is congenital. It is considered as one of the most common congenital abnormality.

Appendicitis: Inflammation of appendix is known as appendicitis. Patient experiences pain in the lower right abdomen, loss of appetite, and nausea and vomiting.

What Are The Various Specializations Of Pediatric Surgeon?

Following are the various specializations of the pediatric surgeon:

Neonatal

Prenatal

Trauma

Pediatric oncology

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Vesicoureteric Reflux

What Is Vesicoureteric Reflux?

Vesicoureteric reflux is the condition in which the urine flows back from the bladder to the ureter. This condition is also known as vesicoureteral reflux. There is a progressive flow of urine from the kidney to the bladder through ureters. The uni-directional flow of urine from kidney to urinary bladder is ensured by the flaps situated between the ureter and urinary bladder (vesico-ureteric junction). This condition is commonly diagnosed in infants and young children.

In this condition, the urine may flow back form one or both the ureters. Based on the severity of symptoms and extent of disease, the urologist generally grades this condition from Grade 1 to Grade 5 with Grade 1 mildest form and Grade 5, a severe form. Fortunately, most children recover from this condition as they get older. The vesicoureteric reflux is divided into primary and secondary.

What Are The Causes Of Vesicoureteric Reflux?

The causes of vesicoureteric reflux are different for primary vesicoureteric reflux and secondary vesicoureteric reflux.

Primary vesicoureteric reflux: In this type of vesicoureteric reflux, the valve between the ureter and urinary bladder does not work properly. This results in backflow of urine. This is the most common cause of this condition in children. However, as the age increases, the ureter and bladder become mature, and the valve regains functioning. If the urine flows back from only one ureter, it is termed as vesicoureteric unilateral reflux, and if both the ureters are involved in the backflow of urine, the condition is termed as vesicoureteric bilateral reflux.

Secondary vesicoureteric reflux:There are various causes of secondary vesicoureteric reflux. In some cases, there is a blockage of urine due to abnormal tissue fold in the urethra (posterior urethral valve) and in conditions like neurogenic bladder . Obstruction in bladder outlet prevents the voiding of complete urine from the bladder. In cases of neurogenic bladder, the child may also have damaged nerves that control contraction and relaxation of the bladder resulting in reflux.

What Are The Symptoms Of Vesicoureteric Reflux?

Symptoms of vesicoureteric reflux depend upon the severity and complications of the disease. The patients with vesicoureteric reflux may experience the following symptoms:

Recurrent urinary tract infection

The excessive urge to urinate

Fever

Cloudy urine

Frequent urination

Pain during urination

Bedwetting

Urinary retention

Loss of appetite

Irritability

Presence of protein in the urine

High blood pressure

How Vesicoureteric Reflux Is Diagnosed?

The vesicoureteric reflux can be diagnosed both before and after birth. Before birth, the condition can be diagnosed through the ultrasound, which reveals swelling in kidneys (hydronephrosis). Various techniques that are used to diagnose the condition are:

Laboratory workup: Many children have the recurrent urinary infection as the primary symptom of this condition. Thus, urinalysis is done to determine the presence of urinary tract infection.

Imaging techniques: Kidney, bladder, and ureter ultrasound is done to determine the presence of any structural abnormalities.

Micturating cystourethrogram (MCUG):It is a specialized X-ray of the urinary tract. During this procedure, the doctor places a small catheter in the bladder and fill the bladder with a special dye. The X-ray is taken before and after urination. The doctor, by evaluating the flow of dye, determines if the urine flows back in the ureter.

Nuclear scan:During this procedure, the doctor uses a radioisotope. The detector detects the isotope and determines any damages in kidney.

How Vesicoureteric Reflux Is Treated?

The following are the management options available for vesicoureteric reflux:

Medications: Low dose of antibiotics is provided to the children to prevent urinary tract infection. However, regular monitoring is required to determine the presence of urinary tract infection. Further, doctors should implement imagining techniques to monitor the progression of the disease. Besides various precautions are to be taken like avoiding constipation, perineal hygine and frequent voiding to reduce the risk of infection.

Surgery: Various types of surgeries are available for treating vesicoureteric reflux. Open surgery is done to repair the larger problem in the urinary tract and involves anesthesia. Robotic-and laparoscopic surgery is done to repair the valve between the ureter and urinary bladder. Endoscopic surgery is performed to strengthen the valve with the use of a bulking agent. Ureteric reimplantation is surgery in which the doctor disconnects the ureter and urinary bladder and reattaches them at an angle to create a valve.

What Are The Preventive Measures For Vesicoureteric Reflux?

Although there are no measures to prevent the vesicoureteric reflux,  certain measures may improve the health of the urinary tract. These are:

Regular urination and cleaning from front to back.

Drinking enough fluids.

Eat plenty of fiber-rich food to avoid constipation.

Change the diaper frequently or as soon as it gets dirty.

Get proper treatment for urinary and fecal incontinence.

What Is The Prognosis Of Vesicoureteric Reflux?

Most children with this condition recover on their own. Surgery has a high rate of success, with a 97%-99% positive outcome. Early diagnosis and monitoring of the condition reduces complications.

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Dr. Prashant Jain sounds is accomplished and dedicated pediatric surgeon and urologist

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Hydronephrosis Treatment In Delhi

Many people have never heard of the term hydronephrosis. That’s because it is only prevalent in around 1% of the general population according to a research paper published by Science Direct. Hydronephrosis can affect both children and adults. In fact, it can even affect babies in the womb; this can be found via prenatal ultrasound. The same study by Science Direct observed that 1 in 100 to 200 fetuses suffered from hydronephrosis. Because of this, finding out that you suffer from hydronephrosis and require surgery might seem daunting. But don’t worry about it. You can find hydronephrosis treatment in Delhi without breaking a sweat!

What exactly is it?

Hydronephrosis is a condition wherein one or both of the kidneys swell up. This happens either because of some blockage in drainage system of urineor urine refluxing back in the kidneys which can eventually damage the kidney of child.

Therefore, it is essential that you consult doctor once hydronephrosis has been diagnosed. Once the diagnosis is made child needs to be evaluated in detail. Not all hydronephrosis requires surgical intervention but needs to be monitored closely to avoid any renal damage.

Signs of Hydronephrosis

Here are some of the most commonly known signs and symptoms of hydronephrosis.

Antenatal diagnosis on ultrasound scan.

Urinary tract infection

Pain and lump in the back and the sides.

Urinary symptoms like frequent urination, crying during urination etc.

These signs are particularly useful to suspect hydronephrosis in children. Infants, in particular, can have failure to thrive. If you have suspicion that your child may be suffering from hydronephrosis or has all the signs mentioned above, it might be a good idea to consult a doctor.

Causes of Hydronephrosis

As mentioned above, hydronephrosis is a condition that prevents urine draining from the kidneys, which causes the kidneys to swell up. Hydronephrosis usually develops because of two main causes:

Obstruction in Urinary System

Blockage in the upper ureter (Pelvi-ureteric Junction) or lower ureter (Uretero-vesical junction) or Bladder oulet (Posterior urethral valve) can cause hydronephrosis on one side or both sides.

One of the commonest cause is blockage at ureteropelvic junction. This is essentially the very point (or junction) where the ureter and kidney meet.

Posterior Urethral valves are seen in boys and usually causes bilateral hydronephrosis. This is treated by endoscopic resection surgery. If not treated timely it can cause significant morbidity.

Vesicoureteral Reflux

Another cause of hydronephrosis is the vesicoureteral reflux where the urine flows backward from the bladder to the kidneys via the ureter. This condition is unique because usually the urine should only flow from the kidneys to the bladder- not the other way around.

Hydronephrosis treatment in Delhi

If you’re looking for hydronephrosis treatment in Delhi, then you’ll be happy to know that there’s plenty of options available. Your doctor who, after examination, ask for a few tests. This may include the following:

Blood test

Urine test

Ultrasound Imaging

Voiding Cystourethrogram

Renal Scan (DTPA or DMSA scan)

Combined, these tests examine your kidneys, bladder, Urethra and checks if they’re working fine. The kind of treatment you’ll receive for hydronephrosis depends strictly on how severe the condition is.

Some of the causes are self-limiting and may need just close observation with regular testings. Hydronephrosis causing recurrent urinary infections or deterioration of renal functions might require surgical intervention.

However, we do not recommend that you go with this approach as it can even lead to your mild case developing into a severe case of hydronephrosis, which will need surgery. Hydronephrosis surgery cost depends solely on how critical the situation is.

However, you should not look at hydronephrosis surgery costs when looking to treat the disease. As we mentioned, it’s not life-threatening at the same time living with hydronephrosis can severely impact your quality of living. So don’t wait it out!