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Nowadays, ultrasounds can very accurately tell us the sex of the future baby, unless the parents want to keep the intrigue until the end. In fact, not so long ago, it was the father who was in charge of informing the rest of the family if it was a boy or a girl, with a cry of joy or a grimace of contained disappointment, depending on the gender preferred during pregnancy. It matters little, in the end they are loved the same.
It was enough to fix the gaze on a certain part of the human body. Excellent results, even without medical knowledge, with an accuracy of 99.99%. In rare cases, known as intersex states, the external genitalia are ambiguous, and you don't really know what to say. I even remember a father who, sobbing, told me that his son had been born transsexual. Although it may generate a laugh, at that moment I sat down with him, told him that we would study it and that everything had a solution.
When the presence of penis and scrotum does not raise doubts, alarms go off in a significant percentage of cases, up to 2-3% of male newborns: “Doctor! My son doesn't have testicles! " The most common expression substitutes the last word for the oval with shell that the females of some animals put. In medicine we call it cryptorchidism, a word of Greek origin, kryptos (hidden) and orkhis (testicle), which means "absence of testicles in the scrotum. The most common is that it affects only one (unilateral cryptorchidism), although it can also affect both (bilateral cryptorchidism). What to do when the boy's testicles do not drop down?
Cryptorchidism is more common in premature babies and, in most cases, the testicle will complete its normal descent into the scrotum during the first six months of life, so that at nine months this situation only persists in 0.8 % of the kids. From the year of life, if the testicle has not descended, it is already exceptional that it does.
- But doctor! Descend from where? Don't tell me the stork has been forgotten and they are going to send it to me by express delivery!
- No, no, it descends from the abdomen.
- From the stomach? Honey, pick things up. We go to another hospital that this pediatrician is crazy.
During embryonic life, the testes form similar to the ovaries, close to the kidneys. Towards the end of pregnancy, while the ovaries remain in the abdominal cavity, the testicles begin a one-way trip to the scrotal bags. And why do they descend? Because male gonads need lower temperatures than those present inside the abdomen, about 1 degree lower. Hence, you have ever heard that the famous briefs type are not ideal for men, because we subject the testicles to an excess of heat that will not help our fertility.
And this issue of fertility is also important when there is cryptorchidism and it does not resolve during the first months of life, since the testicle that remains in the abdomen will also be subjected to an excessive temperature, and will end up not working well. In addition, there is an increased risk of urological problems such as testicular torsion and the development of tumors. Therefore, when the boy's testicles are not lowered, they must be lowered.
How is it forced to slide into the scrotal bag? Currently, the most common is to perform a small surgery called orchidopexy, which tries to fix the rebellious testicle in its proper position. It is recommended to intervene before two years of life, to avoid loss of fertility and prevent complications. Medical treatment is also possible through the administration of certain hormones. It will be the pediatrician who indicates which is the best solution in each case.
There are also times when there is simply no testicle. Neither the scrotum nor the abdomen. It has not developed. In this situation, it is possible to place a prosthesis to prevent possible psychological problems in the future.
Finally, we must recognize well a situation much more common than cryptorchidism, which is called retractile testicle, or "elevator", and against which nothing needs to be done. Its own name already says it, it is a testicle that rises and falls easily. Sometimes it is and sometimes it is not. Although the retractile testicle can be lowered from the inguinal canal through simple maneuvers with the fingers of the hands, it can also be differentiated from cryptorchidism when the child has a fever or we give him a bath with hot water. In these situations, the testicle seeks refreshment and tends to settle in its usual place in the scrotal sac. This should give you peace of mind.
In short, if you almost always notice the testicles in the pouch, don't worry. On the contrary, if they are almost never or never, or even have not located them for a long time, then consult your pediatrician. Although it is rare, sometimes there are cases of testicles that, once descended, rise again, and will also end up requiring treatment.
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