Growth guide for parents of babies with cryptorchidism

Title: Growth guide for parents of babies with cryptorchidism

Author: Zhang Lijuan, Chief Nurse, Department of Pediatric Surgery, Seventh Medical Center of the PLA General Hospital.

Xia Qiao, Chief Nurse of Pediatric Surgery Ward, Seventh Medical Center, PLA General Hospital.

Reviewer: Wang Xianqiang, Deputy Chief Physician, Pediatric Surgery Ward, the Seventh Medical Center of the PLA General Hospital.

Introduction: Cryptorchidism in baby boys can affect future fertility if untreated. This article educates parents on causes, risks, and treatments.

Dear parents, welcome to the adventure story of 'Little Egg'! In this journey full of unknowns, some 'little eggs' may get lost, but don't worry. As your health navigator, I will guide you in a fun and light-hearted way to uncover the mysteries of undescended testicles and help find those little ones who have gone astray!

The Lost Little Egg — What is Cryptorchidism?

Every little boy is born with two 'little balls' (medically known as testicles) residing in his body. Normally, they should gradually slide down from the baby's abdomen into the scrotum along a 'slide' (inguinal canal) during the seventh to ninth month of pregnancy. However, some mischievous 'little balls' may get lost along the way, hiding in the groin, abdomen, or even becoming completely 'invisible' like ninjas. This condition is medically referred to as cryptorchidism and is one of the most common congenital urinary system issues in male infants.

Why did the little egg get lost?

The process of the descent of the baby’s testicles requires the guidance of androgens, such as testosterone. These hormones act like 'navigational signals,' directing the testicles to descend smoothly into the scrotum. If there is insufficient hormone secretion, the small testicles may 'not receive the navigational signals,' leading to the inability to descend properly and causing cryptorchidism. In addition to hormonal factors, mechanical obstacles are also an important cause of cryptorchidism. The inguinal canal acts like a 'slide' for the testicles' descent; if this 'slide' is too narrow or if there are adhesions, the testicles may get stuck midway and fail to reach the scrotum. Similarly, underdeveloped gubernaculum testis can also affect the descent of the testicles; this gubernaculum acts like a 'tether,' and if it is not strong enough or its length is insufficient, the testicles cannot be successfully pulled into the scrotum. Additionally, genetic factors should not be overlooked. If the father or brothers have a history of cryptorchidism, the risk for the baby to have this condition is slightly higher.

The Dangers of Cryptorchidism — Why Is It Important to Address It Early?

Cryptorchidism not only impacts aesthetics but may also bring about numerous health risks. Firstly, the scrotum acts like a 'constant temperature air conditioner,' maintaining the testes at a temperature 1-2°C lower than the body's temperature. This cooler environment is essential for sperm production. If the testes remain in the warmer abdominal cavity for an extended period, the sperm factory can be damaged, leading to a decline in fertility, which may affect reproductive capacity in the future. Secondly, boys with undescended testes face a risk of testicular cancer that is 5-10 times higher than that of normal boys. Even if surgery is performed to secure the testes in the scrotum, this risk persists, necessitating long-term follow-up. Additionally, testes trapped in the inguinal canal are easily subjected to friction from diapers or pants and may even experience testicular torsion, a condition that requires emergency surgical intervention.

How to find the lost egg?

The treatment options for babies with cryptorchidism mainly include medication and surgical intervention. Medication primarily involves the use of human chorionic gonadotropin (HCG) or gonadotropin-releasing hormone (GnRH) to stimulate the descent of the testes; however, the success rate is limited and it is mainly applicable to certain cases. Surgical treatment is currently the most common and effective method, with two main techniques available. One is traditional open surgery, where the doctor makes a small incision in the groin to locate the testes and secure them in the scrotum. This approach is straightforward but may leave noticeable scars. The other method is laparoscopic minimally invasive surgery, which is increasingly recommended for various types of cryptorchidism. During the procedure, the doctor creates a small incision near the navel and employs a camera and slender instruments for precise operations. The advantages of laparoscopic surgery include minimal trauma, quick recovery, and virtually invisible scars, which have less impact on the baby's physical and psychological well-being.

Post-Operative Follow-Up - Protecting the Future of Our Little Eggs

The success of the surgery is just the first step in the treatment of infants with undescended testicles. They will require long-term monitoring and follow-up. Beginning in puberty, regular monitoring of testicular development is necessary, including checking the size of the testicles and hormone levels. Additionally, from puberty onward, children should learn to perform a monthly self-examination of their testicles. Normal testicles have a smooth, elastic surface without any lumps. If there are any abnormalities such as enlargement, hardness, or pain in the testicles, medical attention should be sought immediately.

Warm conclusion: Each baby is a brave little warrior; the lost eggs are just a minor episode on the journey of growth. Modern medicine can help the vast majority of babies with undescended testicles return to normal. What parents need to do is 'early detection, early treatment, and regular check-ups,' supporting their children as they smoothly navigate this fantastic journey!

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