Undescended testis (a testicle that has not come down)Undescended testis (testicle jo neeche nahi utra)

Undescended testis kya hai

Testicle sperm aur mardana hormone testosterone banate hain. Larke ke paida hone se pehle har testicle pait ke andar banta hai aur phir ran (groin) se guzar kar scrotum, yaani penis ke neeche ki thaili, mein utarta hai. Kabhi kabhi aik ya dono testicle raaste mein ruk jate hain. Isay undescended testis (cryptorchidism) kehte hain.

Yeh aam tor par paida hone ke baad doctor ke muaine mein ya walidain ko nazar aane par pakra jata hai ke scrotum ki aik taraf khali ya chhoti hai. Yeh aam aur qabil-e-ilaaj masla hai. Walidain ke liye aham baat yeh hai ke jo testicle theek umar tak neeche na aaye usay chhote operation se theek karna chahiye, aur dekhte rehne par nahi chhodna chahiye. Yeh guide batati hai ke kyun, aur kya umeed rakhni chahiye.

Yeh kisi ki ghalti nahi. Yeh na hamal ke dauran maa ke kiye hue kisi kaam se hota hai, na bhaari cheez uthane se, na girne se, na walidain ke kisi kaam ya kisi kaam na karne se.

Qismein: undescended, retractile aur doosri

Har khali nazar aane wale scrotum ka matlab aik hi nahi hota. Tajarbe-kaar doctor farq bata sakta hai:

• Haqeeqi undescended. Testicle ran ya pait mein phansa hua hai aur scrotum mein nahi laya ja sakta.
• Retractile. Testicle kabhi kabhi scrotum mein hota hai, lekin khaas tor par jab bacha thanda, dara hua ya muaina ho raha ho to oopar ran mein chala jata hai. Isay aahista se neeche laya ja sakta hai aur woh kuch der wahan rehta hai. Yeh qism aam tor par nuqsan-rahit hai, lekin doctor se waqtan fowqatan check karwana chahiye, kyunke in mein se kuch baad mein oopar hi reh jate hain.
• Ascending. Aisa testicle jo paida hone par theek jagah par tha lekin bachay ke bare hone ke saath dheere dheere oopar chala gaya. Isay operation ki zaroorat ho sakti hai.
• Mehsoos na hone wala. Testicle pait mein bohat oopar hai, bohat chhota hai, ya kabhi paida hone se hi nahi hota. Is ki maahir se jaanch zaroori hai.

Meherbani karke testicle ko khud malne, kheenchne ya dabane ki koshish na karein. Is se kaam nahi hota, aur bachay ko takleef ya pareshani ho sakti hai.

Yeh kitna aam hai

Undescended testis naye paida hone wale larkon mein sab se aam farq mein se aik hai, aur samay se pehle paida hone wale bachon mein zyada aam hai. Aksar aik taraf mutasir hoti hai, kabhi dono. Bohat se bachon mein testicle zindagi ke pehle chand mahino mein khud neeche aa jata hai. Agar woh takreeban chhe mahine ki umar tak neeche na aaye to us ke khud aane ka imkaan kam hai, aur bachay ko specialist ko dikhana chahiye.

Yeh kyun ahem hai

Jo testicle scrotum se bahar rehta hai woh aisi jagah hai jo us ke theek kaam karne ke liye zyada garam hai. Isay wahin chhodne se yeh masail ho sakte hain:

• Baad ki zindagi mein fertility kam hona, khaas tor par jab dono taraf mutasir hon. Testicle ko jaldi neeche lane se usay behtar kaam karne ka mauqa milta hai.
• Mutasir testicle mein testicular cancer ka imkaan zyada hona. Khatra phir bhi chhota hai, lekin aam se zyada hai, aur jo testicle mehsoos na ho us mein ganth ka pata chalna mushkil hota hai.
• Testicle ke mur jane ka imkaan zyada hona (dekhein testicular torsion guide).
• Hernia, ran mein ubhaar, jo aksar undescended testis ke saath hota hai.
• Shakal ki fikar. Bachay ke bare hone par khali scrotum sharminda kar sakta hai.

Operation, jise orchidopexy kehte hain, cancer ka khatra poori tarah khatam nahi karta, lekin testicle ko aisi jagah la deta hai jahan usay mehsoos aur check kiya ja sakta hai, aur us ki nashonuma behtar hoti hai.

Kaise pakra aur check kiya jata hai

Aap ka doctor:

• Bachay ka muaina karega, garam hathon se, aaramdeh position mein, aam tor par leta hua ya paon mod kar baitha hua. Yeh bunyadi test hai, aur be-dard hai.
• Doosri taraf aur baqi genitals ki jaanch karega, kyunke kuch bachon mein doosre farq bhi hote hain.
• Aam tor par ultrasound nahi likhta. Is halat mein scan gumrah kun ho sakta hai, aur jo doctor bachay ka theek muaina kar sake usay is ki zaroorat nahi. Yeh khaas halaat mein istemal ho sakta hai.
• Kabhi mazeed tests likhta hai, agar dono testicle mehsoos na hon ya doosre farq maujood hon, nadir hormone ya genetic halaat ki jaanch ke liye.
• Agar testicle mehsoos na ho to behoshi mein camera ke zariye pait ke andar chhoti keyhole jaanch ki ja sakti hai, aam tor par ilaaj ke saath hi.

Agar koi doctor kahe ke yeh bara hone par ya balaghat par khud neeche aa jayega, to meherbani karke intezar na karein. Bachon ke surgeon ya paediatric urologist ke paas refer karne ko kahein.

Ilaaj ke tareeqay

Ilaaj qism aur testicle ki jagah par mabni hota hai.

Undescended testis ke ilaaj ke liye hormone ke injection ya spray aam tor par tajweez nahi kiye jate. Meherbani karke is ke liye dawai ki dukaan ya hakeem se dawaiyan, tel ya marham na khareedein. Woh kaam nahi karte, aur operation mein der karwate hain.

Operation ke baad

Zyadatar bachay jaldi theek ho jate hain aur usi din ghar chale jate hain. Doctor batayega ke kya umeed rakhni chahiye aur zakhmon ki dekh bhaal kaise karein. Aam tor par:

• Dard ki dawai doctor ke mashware se dein, aur zakhm saaf aur khushk rakhein.
• Surgeon jitni muddat batayein, sakht khel, cycle chalane, chadhne wale khilone aur ran ko dabane wali har cheez se parhez karein.
• Bukhar, barhti hui surkhi, behte hue zakhm, ya barhti hui soojan par nazar rakhein.
• Follow-up visit par jayein, taake doctor testicle ki jagah aur nashonuma dekh sake.

Jaise jaise larke bare hon, unhein mahine mein aik baar apne testicle check karna sikhayein (dekhein testicular cancer guide), khaas tor par agar aik undescended tha.

Bare bachay aur mard

Kabhi masla der se, kisi nau-jawan ya baalig mein pakra jata hai. Urologist ko dikhane mein abhi bhi der nahi hui. Maqsad ab bhi fertility ki hifazat, testicle ko check karna aasaan banana, aur cancer ka khatra kam karna hai, lekin ilaaj har maamle ke mutabiq tay hota hai. Baalig mein agar testicle bohat oopar ya chhota ho aur doosri taraf sehatmand ho to kabhi usay nikalne ka mashwara diya jata hai. Meherbani karke urologist se baat karein, aur agar fertility aham ho to male infertility guide dekhein.

Aam sawalaat

What an undescended testis is

The testicles make sperm and the male hormone testosterone. Before a baby boy is born, each testicle forms inside the tummy and then travels down through the groin into the scrotum, the bag of skin below the penis. Sometimes one or both testicles stop on the way. This is called an undescended testis (cryptorchidism).

It is usually found by the doctor at the newborn check, or by parents who notice that one side of the scrotum looks empty or smaller. It is a common and treatable condition. The key point for parents is that a testicle that has not come down by the right age should be fixed with a small operation, and not left to see what happens. This guide explains why, and what to expect.

It is nobody's fault. It is not caused by anything the mother did in pregnancy, by lifting, by a fall, or by anything the parents did or did not do.

Types: undescended, retractile and others

Not every empty-looking scrotum means the same thing. An experienced doctor will tell the difference:

• Truly undescended. The testicle is stuck in the groin or tummy and cannot be guided into the scrotum.
• Retractile. The testicle sits in the scrotum at times, but moves up into the groin, especially when the child is cold, frightened or being examined. It can be gently guided down and stays there for a while. This type is usually harmless, but it should be checked by a doctor from time to time, because some of these testicles later stay up.
• Ascending. A testicle that was in the right place at birth but gradually ends up higher as the child grows. It may need an operation.
• Cannot be felt. The testicle is high inside the tummy, very small, or sometimes missing from birth. This needs a specialist check.

Please do not try to massage, pull or press the testicle down yourself. This does not work, and it may upset or hurt your child.

How common it is

An undescended testis is one of the most common differences seen in newborn boys, and is more common in babies born early. Often one side is affected, sometimes both. In many babies the testicle comes down by itself during the first few months of life. If it has not come down by around six months of age, it is unlikely to do so, and the child should see a specialist.

Why it matters

A testicle that stays outside the scrotum is in a place that is too warm for it to work well. Leaving it there can cause:

• Lower fertility later in life, especially if both sides are affected. Bringing the testicle down early gives it the best chance to work well.
• A higher chance of testicular cancer in the undescended testicle. The risk is still small, but it is higher than normal, and it is harder to notice a lump in a testicle that cannot be felt.
• A higher chance of the testicle twisting (see the testicular torsion guide).
• A hernia, a bulge in the groin, which often goes with an undescended testis.
• Worry about appearance. As boys grow, an empty scrotum can cause embarrassment.

The operation, called orchidopexy, does not remove the cancer risk completely, but it brings the testicle into a place where it can be felt and checked, and it improves its growth.

How it is found and checked

Your doctor will:

• Examine your child with warm hands, in a relaxed position, usually lying down or sitting cross-legged. This is the main test, and it is painless.
• Check the other side and the rest of the genitals, because some children have other differences too.
• Not usually need an ultrasound. A scan can be misleading in this condition, and a doctor who can examine your child properly does not need one. It may be used in special cases.
• Sometimes arrange further tests, if both testicles cannot be felt or if other differences are present, to check for rare hormone or genetic conditions.
• If a testicle cannot be felt, a small keyhole look inside the tummy with a camera may be done under anaesthetic, usually at the same time as the treatment.

If a doctor tells you "it will come down by itself when he grows up" or "at puberty", please do not wait. Ask for a referral to a children's surgeon or paediatric urologist.

Treatment options

Treatment depends on the type and on where the testicle is.

Hormone injections or sprays are not usually recommended for treating undescended testes. Please do not buy medicines, oils or ointments from a chemist or hakeem for this. They do not work, and they delay the operation.

After the operation

Most children recover quickly and go home the same day. The doctor will tell you what to expect and how to look after the wounds. In general:

• Give pain relief as advised, and keep the wounds clean and dry.
• Avoid rough play, cycling or climbing toys, and anything that squeezes the groin, for the time your surgeon advises.
• Watch for fever, increasing redness, a leaking wound, or swelling that gets worse.
• Keep the follow-up visit, so that the doctor can check the position and growth of the testicle.

As boys grow up, they should be taught to check their testicles once a month (see the testicular cancer guide), especially if one was undescended.

Boys and men who are older

Sometimes the problem is found late, in a teenager or an adult. It is not too late to see a urologist. The aim is still to protect fertility, make the testicle easier to check, and reduce cancer risk, but treatment is decided case by case. In an adult, if the testicle is very high or small and the other side is healthy, removing it is sometimes advised. Please talk to a urologist and, if fertility matters, see the male infertility guide.

Common questions