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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20388
Experience:  I am fellowship trained specializing in general urology and reconstructive urology.
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My son is 10 years old and has an undescended testicle.

Customer Question

My son is 10 years old and has an undescended testicle. Actually it had descended and has reascended and is in the inguinal canal. Orchiopexy has been recommended. Is this procedure necessary? What is the likelihood that the testicle will descend on its own? I would prefer not to put my son through this surgery especially at his age. He has already started puberty. What are the risks of not treating this testicle? I understand a slight increase in testicular cancer, testicular torsion and reduced fertility but weighing these risks against the risks of surgery I am not convinced this is the best choice. Would it be possible to use ultrasound to monitor this testicle for any changes and leave it alone?
Submitted: 1 year ago.
Category: Urology
Expert:  Dr. Y. replied 1 year ago.

At his age, there is little to no chance that it will come down any further. The fact that it is an undescended testicle makes it at higher risk for developing cancer, and the risk does not decrease if it is brought down surgically. The only benefits from brining the trsticle down to the scrotum are for cosmetic reasons and to allow him to do testicular self exams to monitor for the development of any masses in the testicle. Yearly ultrasound can be performed as an alternative, but in my experience, men never follow through with this as this is something he will have to do until he is in his 50s or so. Surgery is the best option at this point and will be the most convenient for him in the long run. Hope this helps.

Customer: replied 1 year ago.
Thank you for your help. I think it would be less traumatic to get the yearly ultrasounds than to put him through the surgery at this point. The cosmetic reasons are not enough when weighed against the risks of major surgery and anesthesia. What is the increased risk of testicular cancer? At what age should the yearly screening ultrasounds begin?
Expert:  Dr. Y. replied 1 year ago.

If the orchidopexy is done before age 13, the risk of cancer is 2.23 times the normal population. If it is done after age 13, the risk is 5.4 time normal. Therefore, the risk is twice as high is he waits until after age 13. I would recommend it be done now.

Customer: replied 1 year ago.
Do those statistics for the testicular cancer take into account if the testicle is in the abdomen or in the canal. I read that the closer to the scrotum the testicle is the lower the risk of cancer. Is this true? Also if the screening is done on a yearly basis it would potentially see any changes and the testicle could be removed at that time, right?
Customer: replied 1 year ago.
What is the risk of testicular cancer in the normal population?
Expert:  Dr. Y. replied 1 year ago.

Yes. The lower the testicle is, the less the risk of cancer. Yes. Screening could detect a cancer that could be acted upon early. I don't know the exact numbers off the top of my head in the normal population, but it is relatively rare.