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Is It Possible To Delay Surgery For Undescended Testis In Children?

Posted on Thu, 8 Jan 2015

Question: Dear Doctor,

My second son has just been born, and he has a defect in his testis called undescended testis. After discussing with doctor i was shocked to hear they have to have an operation on him. Im very concerned because he's only a baby. With my first son we didnt have this problem

Is it possible to delay the operation until he's a few years older?

Answered by Dr. Deepak Kishore Kaltari (25 minutes later)

Brief Answer:
Surgery is indicated at 6 to 9 months of age

Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day
Dear Mr XXXXXXX

Being a Pediatric Surgeon I routinely come across such cases. Testis usually develop in the abdominal cavity and during growth and development they descend down into the scrotal sac just before birth. In some babies it falls to descend down.

Thorough clinical examination is very important. If the Testis is palpable (also known as palpable undescended Testis ) then in many cases it spontaneously descends down to normal location that is Scrotal sac by 3 months of age. If it does not descend down by that time then it's unlikely to descend.
Orchidopexy will be required by 6 months of age . It is very important to operate by 6 to 9 months of age. As Testis present in abnormal location will damage the Sertoli and leydig cell due to high temperature (Nature has devised Testis is present in scrotal sac as the temperature is 1.5 lower than body temperature which helps in good sperm and hormone production ). Delay in surgery will cause harm to Testis.
Do not be worried the surgical proprocedure is Orchidopexy (it is a day care procedure if the Testis is palpable ). Rest be assured there is no cause for concern.

Do get back to me if you need any further assistance, will be glad to assist you.

Take care

Best regards
Dr Deepak Kaltari
Consultant Pediatric Surgeon

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Kishore Kaltari (28 minutes later)

Thanks for the advice Dr XXXXXXX

Will the operation be done under general anesthetic? Im concerned about this for such a young age? Or is it done under local ?

Regards,
XXXXXXXX

Answered by Dr. Deepak Kishore Kaltari (6 minutes later)

Brief Answer:
Ideally done under caudal anaesthesia with General anaesthesia

Detailed Answer:
Dear Mr XXXXXXX,

Orchidopexy is ideally done under caudal anaesthesia with Endotracheal intubation( General anaesthesia). Depending on Surgeon preference Caudal anaesthesia with sedation can also be given.
Do not worry in hand of Paediatric Anaesthetist there is no cause for concern.

Take Care

Regards
Deepak

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Kishore Kaltari (21 hours later)

Dear Dr. XXXXXXX XXXXXXX Thanks for the valued advcie.

Just one last question, what harm would happen to the testis if we decide to leave it and not operate ?

Thanks and regards,

Answered by Dr. Deepak Kishore Kaltari (4 hours later)

Brief Answer:
Delay in surgery leads to reduction in Sertoli and leydig cell of Testis

Detailed Answer:
Dear Mr XXXXXX

It is proved beyond doubt that of Orchidopexy is not done done by 6 to 9 months of age ,there is reduction in Sertoli cells of Testis . Sertoli cells are involved in spermatogenesis (sperm production ) and may cause fertility issue in later time period.

So it is advisable and recommended to operate at earliest .

Wishing you and your family a very happy and healthy life.

Take care

Best regards
Dr Deepak Kaltari

Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Vaishalee Punj