Cryptorchidism: Treatment, Procedure, Cost and Side Effects

Cryotorchidism basically refers to the condition where a testicle has not descended into the scotum bag before the child is born. This condition is mostly quite rare when it comes to babies that have served the full term of pregnancy, and often occurs predominantly in babies that are prematurely born. The main symptom of this condition is the lack of a testicle where it should be. While it can be alarming at first, the testicle often drops into the scrotum on its own within a few months. Therefore, it is usually considered a condition that is naturally curable.

However, if the testicle does not drop on its own, doctors generally recommend surgery to fix the problem. It is usually recommended that the surgery takes place before the child reaches 18 months of age. This is mainly because early treatment can help lower the risk of other problems later in life, such as testicular cancer and infertility. In case surgery is not an option, cryptorchidism can also be treated with the help of hormone therapy as it may stimulate the testicle to drop into the sac. In case none of the treatments mentioned so far are viable options, saline testicle prosthetics can also be used.

If your child is born without the testicles in the scrotum (which can be determined by sight or touch), then your doctor will first run some tests to determine whether the testicles are even there inside the body, or just undescended. Once that is determined, the first line of treatment will be supportive care. In this, you will just be advised to wait and watch as the testicles normally drop themselves within six months. If that is the case, the treatment is over right then and there.

If the testicles do not drop on their own, your doctor will recommend surgery to bring them down. This surgery is known as orchiopexy and it has a 100% success rate. It is performed by a paediatric urologist. To perform the surgery, one or two incisions are made on the scrotum, the groin, and the abdomen for the surgeon to be able to move the testicle around properly. If the testicles are located high up in the inguinal canal, then the surgeon will perform a laparoscopy to move them. In both cases, only general anaesthesia is administered and you do not have to worry about your baby being knocked out. Normally, the treatment is over with one surgery. However, if the testicles are up in the abdomen, your doctor might recommend two surgeries over the course of a few months.

If the course of treatment is hormone therapy, then human chorionic gonadotropic (HCG) is injected into the child. This eventually allows the testicle to drop, though it is not considered as safe and effective as the surgical procedure. In case none of the procedures work, the doctor can insert a saline prosthetic into the scrotum, which looks and feels exactly like any other scrotum.

A child with an undescended scrotum is eligible for any of the treatments mentioned above. Only children for whom the treatments don’t work are eligible for the prosthetic treatment. Even if the treatments were not administered on babies, they can be effective on preteens and adolescents, though it is normally advised to carry out the treatments before the child reaches 18 months.

If the doctors determine that the child has no testicles at all (as opposed to undescended ones), then most of these treatment options are not viable ones for him. If that is the case, a mixture of hormone therapy to stimulate testosterone along with prosthetics is usually advised.

Most surgeries come with a list of complications and side effects to be vary of. In the case of orchiopexy, the side effects include bleeding and bruising where the incisions were made on the abdomen, scrotum, and groin area. There are chances of the wound becoming infected if proper hygiene is not maintained. Sometimes, the testicle can move back up into the groin area, though this is rare. Testicular atrophy is also a side effect of orchiopexy. In this, the blood flow to the testicle cannot be maintain properly when it has been moved. As a result, the testicle dies and withers away, leaving a hollow sac where it should be. Another possible complication from the surgery can be damage to the vas deferens, which is the tube that connects the urethra to the testicle. As a result of this, it will be difficult for the semen to pass through, leading to complications regarding fertility in the future. There are a few psychological side effects to suffering from an undescended testicle which includes low self-esteem, self-doubt, depression, and anxiety.

Once your child has undergone the surgery, there are some guidelines that you must follow to ensure its success. For a minimum of 2 weeks, the child must not be allowed to play sports, games, or participate in outdoor activities that may cause strain in the groin. The child is also not allowed to ride a bicycle or sit on swings during this time as he may injure himself or cause pressure on the surgical wounds. A follow up examination usually takes place after 2 or 3 months of the surgery.

On an average, it takes at least 2 to 3 weeks to fully recover from the effects of the surgery. By this time, the wounds or incisions should have completely healed and any pain in the area will have gone away completely. The condition is treated the minute the surgery is over.

The price of the orchiopexy surgery in India ranges between Rs. 4,00,000 to Rs. 6,00,000 depending on the doctor you are seeing and hospital he or she is affiliated with.

The results of the treatment are permanent. In rare cases, sometimes the testicle can go back up, but it can be guided down once more with the hand. Once the treatment has taken place, the testicle stays within the scrotum and the condition is considered to be successfully reversed.

Hormone therapy is usually considered the alternative to surgery. In this treatment, human chorionic gonadotropic (HCG) is injected into the child. This eventually allows the testicle to drop, though it is not considered as safe and effective as the surgical procedure. The use of saline prosthetics are also considered to be a fairly alternative means to treating this condition. There are no specific home remedies to alter this condition and the only effective route is to speak with a medical professional.