According to a new study undescended testes is associated with an increased risk of testicular cancer and male infertility, decreased chances of fathering a child

Undescended testicles should not be neglected.
According to a new study published in The Lancet, which involved all liveborn boys in Western Australia born between 1970 to 1999, and followed up over a 40 year period, the incidence of undescended testes was associated with an increased risk of testicular cancer and male infertility, decreased chances of fathering a child.
The testicles normally descend into the scrotum in the third trimester, somewhere between weeks 26 and 34 of fetal life in the mother’s womb. But in about 3% of full-term male infants (born after 37 weeks of pregnancy), both the testicles may not descend into the scrotum at birth, a condition called cryptorchidism (crypto meaning hidden, and orchis is Greek for testicles).

“We advice all infants and children with undescended testes to undergo corrective surgery called orchiopexy between 6 months and 18 months of age”

The number of cases of undescended testicles are much higher in premature infants, who may be born before the testes descend into the scrotum. Many undescended testicles may descend into the scrotum in the first few months of life but beyond 6 months, it may not happen naturally and infants and children usually require to undergo an urological surgery called orchiopexy, in which an undescended testicle is sutured inside the scrotum in male infants or children to correct cryptorchidism.

Undescended testes was associated with more than two times increase in the risk of testicular cancer and use of ART (assisted reproductive technology) for infertility treatment. Undescended testes was also associated with a 21% reduction in chance of fathering a child. Risk of both testicular cancer and infertility go up if one delays the corrective surgery. For every 6 months’ delay in the surgery – orchiopexy – there was a 6% increase in risk of testicular cancer, a 5% increase in risk of future use of ART, and a 1% reduction in paternity.

Dr. Mahendra Sharma
Dr. Mahendra Sharma

Dr Mahendra Sharma, consultant urologist at Indraprastha Apollo Hospitals, New Delhi said, “We advice all infants and children with undescended testes to undergo corrective surgery called orchiopexy between 6 months and 18 months of age as it significantly reduces their chances of developing testicular cancer and infertility in later life.”

“We know guidelines recommend surgery by 18 months, but studies show many boys are not operated on by that time. In our study half were later, in others even more,” said lead author Francisco Schneuer, research fellow in child population and translational health at the University of Sydney.

This study provides new evidence to support current guidelines for orchiopexy before age 18 months to decrease the risk of future testicular cancer and infertility. Regular follow up with paediatrician or urologist after 6 months of age is essential to prevent future complications.

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