Dear Knell,
I understand your concern about your son's health and your desire to
find out as much as possible about orchiopexy and alternative
treatments for cryptorchidism. Below is information from a variety of
sources that I hope you will find helpful.
Whenever I start looking for health information I always go to the
MedlinePlus consumer health resource (http://www.medlineplus.gov).
MedlinePlus includes a really good encyclopedia, which has two
articles that I think will get us started (linked and abstracted below
- and no, I do not work for the National Library of Medicine):
MedlinePlus/Adam Health Encyclopedia: Undescended testicle
http://www.nlm.nih.gov/medlineplus/ency/article/000973.htm
"Treatment
Usually the testicle will descend into the scrotum without any
intervention during the first year of life. If this does not occur,
hormonal injections (B-HCG or testosterone) may be given in an attempt
to stimulate movement of the testicle into the scrotum.
Surgery (orchiopexy) is the definitive therapy. The trend in
literature favors earlier surgery to prevent irreversible damage to
the testis, which may cause infertility.
Expectations (prognosis)
The majority of cases resolve spontaneously, without any treatment.
Medical or surgical correction of the condition is usually successful.
About 5% of patients with undescended testicles do not have testicles
that can be found at the time of surgery. This is called a vanished or
absent testis."
MedlinePlus/Adam Health Encyclopedia: Undescended testicle repair
http://www.nlm.nih.gov/medlineplus/ency/article/003002.htm
"Description
While the child is unconscious and pain-free under general anesthesia,
an incision is made in the groin, where most undescended testes are
lodged. The spermatic cord is located and freed from surrounding
tissues to maximize its length. A small incision is made in the
scrotum and a pouch is created. The testicle is carefully pulled down
into the scrotum. The testicle is stitched in place in the scrotum and
the incisions are stitched closed.
Indications
Undescended testicles often descend into the scrotum by 1 year of age.
It is unusual, however, for testicles to descend on their own after
the age of 1 year. This surgery is recommended for infants older than
1 year whose testicles have not descended into the scrotum
(cryptorchidism).
This condition is more common in premature babies. Most often, only 1
side is affected.
Undescended testicles may cause infertility and are more prone to
developing malignant tumors in later years.
Risks
Risks for any anesthesia are:
Reactions to medications
Problems breathing
Risks for any surgery are:
Bleeding
Infection
Expectations after surgery
Undescended testicle repair is successful in most cases. The long-term
prognosis for hormone production and fertility is excellent. A small
percentage (10%) of individuals will have fertility problems, however.
Men who have had undescended testicles should be examined monthly,
throughout their lives, to detect any possible tumor development.
Individuals with undescended testes have a 30- to 50-fold higher rate
of testicular cancer than those with normal testicular development."
In addition, I found this website by searching the MedlinePlus website
for "cryptorchidism". You might also find the MedlinePlus health
topic for Male Genital Disorders helpful for more resources
(http://www.nlm.nih.gov/medlineplus/malegenitaldisorders.html)
FamilyDoctor.org: Undescended Testicles
http://familydoctor.org/637.xml
This suggests two treatments - surgery or an hCG shot (to stimulate
testicular formation).
I next did a search in Google for "cryptorchidism AND treatment" to
find the standard treatments. It appears that surgery is the most
common, approved, and standard treatment for children of your son's
age. The hCG treatment is most often given to younger boys to
stimulate the spontaneous descent of the testicle. Here are some of
the more trustworthy sites that I found:
eMedicine.com: Cryptorchidism
http://www.emedicine.com/med/topic2707.htm
Warning: This is a medical article, and not written in language for
the average parent (I hesitate to send you to it). Have a medical
dictionary handy (example:
http://www.nlm.nih.gov/medlineplus/mplusdictionary.html - the
MedlinePlus dictionary).
This rather lengthy article goes into the diagnosis, treatment, and
long-term effects of cryptorchidism. For your purposes, here's a
quick summary:
- Nonpalpable testicles happen fairly commonly - in 20-40% of the time
they are "absent upon surgical exploration"
- hCG is recommended for children under 1 year of age
- Surgery is strongly recommended for older children (up to age 32)
- This is an outpatient procedure, though your child will be put under
general anesthesia
- Depending on whether your son has hidden testes, the success rate
varies from 67% to 100% (also depending on the procedure)
- There are standard side effects as for any surgery (cut blood vessels, swelling)
Again, I caution you about reading this article - it's very clinical
and would make more sense to your doctor than it may to you (even I
have trouble understanding everything, and I'm a medical librarian!).
American Family Physician: The Undescended Testicle: Diagnosis and Management
http://www.aafp.org/afp/20001101/2037.html
Also a scientific article, for physicians, but less clinical than the above one.
To note, this article suggests that cases involving nonpalpable
testicles (which means, you can't feel them from the outside) are
resolved about 50% of the time.
Intellihealth: Cryptorchidism (Undescended Testicle)
http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/9771.html#treat
This page is geared more towards normal people - but it doesn't have
much information about treatment options.
Wikipedia: Cryptorchidism
http://en.wikipedia.org/wiki/Cryptorchidism
Personally, I love the wikipedia. This is an "encyclopedia" that only
exists on the Internet. It's maintained by anyone who wants to
contribute, and has an amazing wealth of information on pretty much
any topic that someone wants to write about. This article is quite
nice - a good blend between the scientific/clinical aspects of the
articles above with a bit more understandability. You'll be
particularly interested in the "Management" section.
I hope the above resources help you in your search for information
about your son's condition and options. Please let me know if I can
further clarify or supplement any of the above information (preferably
before rating the answer!).
Yours,
Librariankt |
