Testicles large and small in newborns

Small testicles in newborns are quite common phenomenon in recent times, causing a lot of confusion and anxiety for parents. This can be a normal physiological phenomenon, but it can also find a dangerous pathology. Parents need to pay attention to the development of their children to detect them early and take them to a doctor in time.

The testicles on the large side are small or the testicles are irregular or the testicles are misaligned is a phenomenon that the size of the two testicles is unequal, it can be high and low, even in some cases, the testicles on one side are not equal. the other half.
If the baby has small testicles without any abnormal symptoms such as swelling, redness or purple scrotum, crying, refusing to breastfeed, ... then this is a normal phenomenon. It is caused by the uneven development of the testicles, or while one testicle has descended into the scrotum, the other is still in the path from the abdomen. What you need to do is monitor the growth of both testicles.
If the testicle is small and large due to disease, the cause is usually an ectopic or ectopic testicle. This is a dangerous disease, easily leading to dangerous complications such as testicular cancer or male infertility.

Newborn testicles on the small side can be related to some of the following pathologies:
2.1. Undescended testicle This is a common disease and is a top concern for newborns when the testicles are large and small. An undescended testicle is a condition where one or both testicles do not descend into the scrotum but are located in the abdomen. As is known, the temperature in the body is too high for the development of testicles, if the testicles are located in the abdomen, it will damage the physiological and sexual functions of this part. For early detection, parents and caregivers need to check the testicles on both sides. If the testicle is not found on one or both sides, the child should be taken to the doctor immediately.
2.2. Inguinal hernia usually occurs immediately after birth in premature babies or can be several months, a few years after birth, especially after a baby cough, push a lot. This is a phenomenon where the viscera or intestines in the abdomen descend into the inguinal region of the child through the inguinal canal because the inguinal canal is not closed. Parents can see a soft lump located on the baby's inguinal fold and change in size: small when the baby is lying down or larger when the baby cries or pushes. In this case, surgery is the most important treatment. Surgery helps to close the inguinal canal and return the child's organs to the correct anatomical position.
2.3. Hydrocele This is a condition in which fluid in the abdomen will gradually accumulate in the scrotum due to the inguinal canal not closing. Parents will observe that one testicle is enlarged but not painful. This condition may disappear spontaneously as the fluid is absorbed. However, if hydrocele persists after 1 year of age, it is necessary to surgically remove the fluid for the child, then proceed to ligation of the inguinal canal.
2.4. Testicular cyst Parents can observe a round or oval mass located in the scrotum. This mass is usually smooth, painless and located next to the testicle, so parents often think it is the small testicle. Treatment in this case is surgical removal of the cyst when the child is older.

Newborns with small testicles can have acute and chronic complications if not treated promptly
3.1. Acute complication Testicular torsion: This is a condition in which the spermatic cord is suddenly blocked due to the testicle rotating on its own, thereby reducing or completely blocking blood flow to the testicle. The child will suddenly have severe pain in one testicle, and the scrotum will become red or purple. The pain may go away on its own if the child changes position and the testicle is untwisted. However, if the torsion is too long, the testicle can be permanently damaged.
3.2. Strangulated inguinal hernia The viscera or intestines in the abdomen herniated into the inguinal canal can not be pushed out leading to lack of blood supply causing damage. Children will be fussy, have a lot of pain, abdominal distension, vomiting, scrotum swelling and severe pain. If left late, it can lead to necrosis of viscera, testicular damage, and peritonitis.
In addition to acute complications, the condition of small testicles due to pathological causes, if not treated, will leave many long-term complications for children.
3.3. Damaged testicle membrane Newborn baby's testicles are small on the large side due to hydrocele, even damage the testicle because then semen, blood and other substances in the abdomen accumulate, causing the testicles to accumulate. become heavy and saggy. The seminal vesicles must stretch to accommodate stagnant fluids.
3.4. Decreased sperm quality Testicles, if not put in the correct position, will become reduced in quality, affecting the reproductive health of boys for a long time. Typically this condition can lead to low sperm count , low sperm quality .
3.5. Testicular cancer Testicular cancer is rare in men. However, in the case of newborns with small testicles due to medical reasons, there may be an increased risk of testicular cancer for the child. Because the testes in the abdomen do not guarantee the temperature for development, causing the testicles to shrink and possibly turn malignant.

For early diagnosis and treatment of undescended testicles in infants, it is especially important to have regular check-ups by the parents. Accordingly, parents need to check right from the time of birth and regularly check during the child's development. If parents find that the child has a small testicle, or only one or no testicle in the scrotum, or the child's testicles are swollen, painful, red, they need to take the child to the doctor immediately.
Some necessary tests will be carried out to help diagnose a newborn baby with a small testicle.
Ultrasound of the scrotum: helps identify undescended testicles Computerized tomography or laparoscopy helps diagnose in cases where the testicles are not palpable in the scrotum or ultrasound is not visible. Some other tests can also be done to help with the diagnosis such as chromosomal tests, endocrine tests or cancer markers,...

The most common and radical treatment is surgery. This method helps to bring the testicle into the correct position and fix it in the scrotum, allowing the testicle to develop at the right temperature. The most appropriate time for surgery is when the child is 6-12 months old. This is the stage that helps to best improve the function of the testicles and reduce the risk of cancer. In addition, there are a number of methods of treatment with drugs or hormones. However, this is only a temporary solution while preparing the child to be eligible for surgery.
Small testicles in newborns are genital abnormalities that need to be detected and treated early to ensure sexual function for boys and reduce the risk of cancer. Therefore, when seeing a child showing abnormal signs, parents need to take the child to a medical center for examination and treatment.
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