Post Date April, 15 2023
Many male friends never expected that they would not be able to seek a son for many years, but this was the root cause of the disease that was buried in their childhood.
Director Liu Cundong pointed out that cryptorchidism can lead to testicular atrophy, affecting children's gonadal development, and ultimately leading to male infertility in adulthood.
The skin of the scrotum is characterized by a thin epidermal layer, multiple deep wrinkles, rich sweat glands, and loose subcutaneous adipose connective tissue. These characteristics make the temperature in the scrotum lower by 1.5-2.0 ℃ than body temperature, which is necessary for maintaining testicular development and normal physiological function. If the testicle is not inside the scrotum, changing its living environment, the seminiferous tubules will atrophy, affecting sperm growth, and seriously impeding future reproductive function.
"In addition, cryptorchidism also has the possibility of developing testicular tumors, even if the testicle is pulled to the scrotum or the contralateral normal testicle, there is still the possibility of malignant transformation." Director Liu Cundong explained that the location of the undescended testicle affects the relative risk of testicular tumors, and the higher the location, the greater the risk of malignant transformation. It is reported that 2.8% of cryptorchidism patients have unilateral or bilateral testicular tumors or carcinoma in situ. The probability of testicular tumors in cryptorchidism patients is 4-6 times higher than in normal individuals.
Treatment of cryptorchidism should not be delayed as soon as possible
Cryptorchidism is extremely harmful to male infants, and should be treated as soon as possible once it is discovered. However, some parents worry that their baby is too young to bear the pain of surgery, so they shelve it and delay treatment, resulting in a poor prognosis. So, when is the best time to treat cryptorchidism?
Director Liu Cundong stated that the ideal age for retaining fertility is 12 to 24 months after birth. The spontaneous descent of the testis can be completed within 3 months of birth. The definitive treatment for undescended testicles should be completed between 6 and 12 months after birth.
Generally speaking, the younger the age, the better the surgical effect in the treatment of cryptorchidism. However, for children under 1 year of age with cryptorchidism, as testosterone levels increase, it is possible to automatically drop into the scrotum. If the testicle does not descend into the scrotum after conservative treatment, or if it is complicated with indirect inguinal hernia or ectopic testicle, surgical treatment must be taken before the age of two years.
Patients with cryptorchidism before the age of 1 year can choose hormone therapy for conservative treatment. Cryptorchidism can be accompanied by abnormalities in the hypothalamic pituitary gonadal axis. Hormone therapy uses HCG, LHRH, or both. If conservative treatment is ineffective, surgical treatment should be carried out as soon as possible.
Late removal of testicles to prevent cancer in cryptorchidism
Many male friends only discover cryptorchidism when they visit a hospital due to infertility. At this time, the undescended testicles not only lose the ability to produce sperm, but also have the possibility of malignant transformation at any time. The doctor had to suggest that the testicles be removed, which was truly regrettable.
When some boys were young, their parents did not pay attention and did not promptly detect and treat cryptorchidism. Waiting until after puberty to see a doctor in a hospital has already missed the optimal treatment period, and the treatment effect is not ideal.
Director Liu Cundong explained that the main function of the testicle is to produce sperm and androgens. The treatment effect of adult cryptorchidism mainly depends on whether it is unilateral or bilateral. If it is bilateral, the effect may be relatively poor. If the contralateral testicle is normal, it may have a relatively small impact on fertility and hormone levels, and the treatment effect after surgery will be much better.
"For patients with unilateral cryptorchidism, testicular resection should be performed considering that the male hormones produced by the contralateral normal testicle are sufficient to maintain the normal life of the male, while the cryptorchidism has lost its spermatogenic ability and may undergo malignant transformation.". For patients with bilateral cryptorchidism, at least one testicle should be fixed in the scrotum to maintain the source of male hormones. If the other testicle is difficult to fix, it should also be removed.
In addition to affecting testicular development and leading to decreased testicular spermatogenesis, cryptorchidism also has a potential risk of canceration. When the testicular texture of the affected side becomes hardened, there is a tendency to become cancerous, or testicular biopsy confirms that it has become cancerous, active orchiectomy is required.
(Intern Editor: Pan Jindi)
