Undescended Testicle Treatment in Paris
Dr. Adam Vardi - Urologist
Testicular ectopia in Paris
Consultation & Follow-up for Undescended Testicles in Paris
Testicular ectopia, clinically defined as cryptorchidism when the testicle is arrested along its normal path, is the most common congenital anomaly of the male genital organs. It affects approximately 3% of full-term newborns and up to 30% of premature infants. This condition is characterized by the absence of one or both testicles in the scrotum at birth.
Management by the urologist is guided by strict international guidelines, as the extra-scrotal position of the testicle poses long-term risks to fertility and cancer risk.
Pathophysiology of testicular descent
Urological Surgery in Paris & Neuilly
During fetal development, the testicles initially develop in the abdominal cavity, near the kidneys. Under the influence of hormonal (particularly testosterone) and mechanical factors, they begin to migrate toward the groin, pass through the inguinal canal, and normally reach the scrotum before birth.
There are two clinical scenarios:
- Undescended testicle (cryptorchidism): The testicle has stopped prematurely along its physiological path (abdomen, inguinal canal, or superficial opening of the canal).
- True ectopia: The testicle has deviated from its normal path and is located in an abnormal position (between the thigh and the scrotum, or in the pubic region) .
- The “elevator” (or retractile) testicle: This is a testicle that can be manually brought down into the scrotum but rises again due to an overly strong cremasteric reflex. This specific case generally does not require surgery but does require regular monitoring.
Early Diagnosis of Undescended Testicles in Paris
Dr. Adam Vardi - Pediatric Urology
Keeping the testicle in the scrotum is not just a matter of aesthetics; it is a physiological necessity. The temperature inside the abdomen is about 2°C higher than that of the scrotum. Prolonged exposure to body heat impairs the development of germ cells, which will eventually produce sperm.
Initial Assessment and Follow-Up of an Undescended Testicle
Urologist in Paris
Fertility preservation
Histological studies show that cellular damage begins as early as 12 to 18 months of age. Early surgical correction helps maximize the chances of fertility in adulthood, particularly in bilateral cases.
Risk of tumor progression
An undescended testicle carries a statistically higher risk of developing a malignant tumor in adulthood. Surgery does not completely eliminate this risk, but it does allow the testicle to be placed in a position where self-examination by palpation is possible, ensuring early diagnosis in the event of an abnormality.
Risk of testicular torsion
A testicle that is not fully descended or is located in the inguinal canal is more susceptible to torsion, a surgical emergency that results in the interruption of blood flow to the testicle.
Diagnosis and Treatment Strategy
The diagnosis is primarily clinical. During the consultation, Dr. Vardi performs a thorough palpation of the inguinal and scrotal regions, ideally on a calm child in a warm environment.
- Imaging (Ultrasound): Although commonly performed, it is not routinely done if the testicle is palpable. It is particularly useful for locating a testicle that cannot be felt clinically within the inguinal canal.
- Diagnostic laparoscopy: If the testicle is not palpable (an “undescended” testicle), a camera-guided examination (laparoscopy) under general anesthesia may be necessary to verify whether the testicle is present in the abdomen or if it is atrophied (agenesis).