Causes of undescended testicles in children

The article is professionally consulted by Master, Doctor Vo Thien Ngon - Urologist, Department of General Surgery, Vinmec Da Nang International General Hospital.

Undescended testicles are a common developmental defect in men. A decrease in the pituitary gland along with the gonads in boys can predispose them to undescended testes. Besides that, there are other reasons.

When the testicle moves from the abdomen to the scrotum, it is affected by a number of factors. In case those factors are affected, it will cause the testicles not to descend to the scrotum and cause undescended testicles. Factors that cause undescended testicles include:
1.1 Hypothalamic, pituitary, and gonadal disorders Hypopituitarism, gonadotropin deficiency causes undescended testes and penile enlargement.
1.2 Abnormal testosterone synthesis Due to lack of enzymes 17α-hydroxylase, 5α-reductase,... makes the testicles not develop normally.
1.3 Hyposensitivity syndrome of androgen receptors When the sensing function of the androgen receptors is impaired they affect the development of male sexual functions including the decline of testicular.
1.4 The influence of estrogen on the movement of the testicles to the scrotum If a pregnant woman takes a lot of diethylstilbestrol or uses an anti-androgen, the fetus is at risk of having an undescended testicle.
1.5 Abnormal development of the testicular-scrotal ligament When the scrotal testicular ligament has an abnormal development, it will cause the testicle to lie high, leading to an inability to descend to the scrotum.
1.6 Other mechanical factors In addition, there are mechanical factors that hinder testicular movement such as short testicular pedicle, fibrosis in the inguinal canal...

Screening your child from an early age is essential to detect problems with your child's genitals including undescended testicles.
When you see that the child has abnormal signs, put your hand into the child's scrotum to check for testicles or to see if there is a tumor in the inguinal canal.
In addition, when the baby's scrotum is underdeveloped, the risk of undescended testicles is quite high.
In many cases, an undescended testicle appears to be intra-abdominal or deep inguinal on examination and will not be palpable.
When you want to be sure if your child has an undescended testicle, you can take your child for an abdominal ultrasound, abdominal computed tomography scan or laparoscopy to determine the exact location of the undescended testicle.
Hormone tests: LH, FSH, prolactin, estradiol and testosterone can be done to diagnose undescended testicles.
The HCG test is a commonly used method to determine whether a testicle is present or not in cases where both testicles are not palpable.
Currently, the technique of sacral anesthesia is one of the techniques used to treat undescended testicles at Vinmec Danang Hospital.

This is a regional anesthetic technique that is performed by introducing local anesthetic into the epidural space through the sacral and sacral fissures. Helps relieve pain during and after surgery for almost all surgical interventions on the lower abdomen and lower extremities such as: Surgery of undescended testicle, inguinal hernia, hydrocele in children. Therefore, sacral anesthesia is also known as transsacral epidural.