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Undescended testicles can cause infertility

 Surgeons perform a corrective surgery on a nine-year-old boy who was diagnosed with an undescended testes at Kenyatta National Hospital in Nairobi. [PHOTO: WILLIS AWANDU/ STANDARD]

A father’s accidental examination on his son led to a diagnosis that helped restore his manhood.

He was applying medicine on the body of the nine-year-old when he realised an abnormality in his testicles.

At nine, the diagnosis had come eight years late.

“He had chicken pox and as I was routinely applying the treatment lotion on his body, I noticed his scrotum was missing one testes, raising my suspicion that all was not well,” he told The Standard on Saturday.

A second and third assessment by the boy’s mother and an expert led to the conclusion that he had an undescended testes that needed to be treated immediately to enable the sperm producing cells function optimally in the rightful place in the scrotum.

The Class Three pupil, with parents Ashford and Sellah by his side, was upbeat ahead of the operation at the Kenyatta National Hospital (KNH) to correct the abnormality.

The corrective surgery was necessary to bring down one of his testes to its rightful position.

Paediatric surgeon Hamdun Said says undescended testicle is a common childhood condition where a boy’s testicles are not in their usual place in the scrotum and the best time for its assessment to be done is immediately after the child has turns one year. Dr Said explains that as a baby boy grows inside his mother’s womb, his testicles typically form inside his abdomen and should move down into the scrotum shortly before birth, preferably about two weeks before birth.

Become damaged

“Near the end of pregnancy from the eighth month, the testis begins to descend to the scrotum because this is a cooler location than other places in the body and best for sperm production,” says the KNH doctor.

If testes remain internally, the sperm producing cells become damaged thus the child could have fertility challenges in future, he adds. Doctors advice parents to check that by the 12 month-mark, the child’s testes can both be felt to avert future fertility problems.

However, Dr Said notes that in most cases, no treatment is necessary, as the testicles usually move down into the scrotum naturally during the first three to twelve months of life.

“It is a condition present in about 100 persons in every 100,000 in a population but treatable when detected early in a 15 to 20 minute procedure depending on its severity and skill of the surgeon,” he adds.

Said says there should be no cause for panic if they do not move down independently in the first 12 months however on the baby’s first birthday, a medical consultation with a child specialist should be sought to prevent damage to these organs as they may affect fertility later.

“For newborn boys, the initial check-up should be performed immediately after birth by the paeditrician and follow-up physical examination carried on to establish whether there has been progress in the them moving down,” he says.

The medic further notes that most cases of undescended testes are diagnosed with a hernia which is described as part of an organ or tissue in the body that pushes through an opening or weak spot in a muscle wall, thus it rests into a space where it does not belong.

“In some cases, hernias are detected through swellings or protrusions on the outer part of the body and through subsequent detailed examinations we establish the exact nature of the hernia,” he says.

For the boy, the 25-minute surgery was to reposition the testicle into the scrotum, a necessary procedure in order to encourage the normal development of sperm in the testicle.

“The surgery involves putting back the tissue back into its proper space, and closing the opening or weakness that had allowed it to form,” says Dr Said.

Development of a tumour

“The undescended testicle is also prone to injury because it is not in the rightful position," notes Said adding that there are also concerns on the development of a tumour later if uncorrected.

He advises that about seven days after surgery, the child should avoid strenuous work and play like riding a bicycle to allow proper healing.

The boy’s mother is encouraging women to check their son’s testes, to ensure cases of undescended testes, are corrected early enough.

And after the surgery, the boy expressed gratitude to the medical team, friends and family and friends for being there for him during the one-day procedure.

“I thank my parents and doctors for treating me,” said the boy who after a seven-day home-rest will be back to books and play.

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