My son may have lost a testicle due to testiclar torsion is the other testicle i!


Question:

My son may have lost a testicle due to testiclar torsion is the other testicle in danger of being lost.?

Our son just had his two month checkup and is missing his left tesitcle. The dr. told us it may have been lost possibly due to testicluar torsion. We have an appt. with a pediatric urologist later this week but are concerned if there is any immediate danger of damage being done to the remaing testicle. Should we be concerned with the remaining testicle or is there nothing to worry about until we meet with the urologist.


Answers:

The lack of a testicle in a 2 month old is more likely going to be an undescended testicle.

The testicles hang loose in the scrotum and in rare cases they are twisted, so that the channel with the blood vessels is tightened. This blocks the bloodflow to the testicles.

Boys with testicular torsion get sudden pain and swelling of the scrotum. The testicles become sore. The condition may be so painful that it causes nausea and vomiting. It will mimic infection (acute epididymo-orchitis) but it is very important to seek urgent treatment.

A salvage rate of 100% is found in patients who undergo detorsion within 6 hours of pain; 20% viability rate if detorsion occurs after 12 hours; and 0% viability if detorsion is delayed greater than 24 hours.

A painless ultrasound of your son's abdomen can see if he has an undescended testicle.

Undescended testicles are fairly common in premature infants, and occur in about 3 - 4% of full-term infants. About 65% of the testicles typically descend by 9 months of age.

Once a testicle has been discovered in the scrotum, it is generally considered descended, even if it is temporarily retracted on a later examination. Sometimes a condition (referred to as retractile testes) will develop, in which the examiner can sometimes locate the testicles and sometimes not.

This occurs because of the strength of the muscular reflex (cremasteric reflex) that retracts the testicles and the small mass of the testicles before puberty. In this instance, the testicles descend at puberty. This is considered a variant of normal and surgical correction is not needed.

Testicles that do not descend by one year of age should be carefully evaluated. The literature suggest that definitive surgery should be accomplished by this age to confirm diagnosis and to lessen the likelihood of permanent testicular damage.

Testicles that do not naturally descend into the scrotum are considered abnormal throughout the patient's life. These undescended testicles have an increased likelihood of developing cancer regardless of whether or not they are brought down into the scrotum.

Bringing the testicle into the scrotum maximizes sperm production and increases the odds of good fertility. It also allows examination for early detection of testicular cancer.

In other cases, such as vanished testis, no testicle may be found upon surgical exploration. This may be due to in utero vascular insult (testicular torsion), resulting in an infarction (death of affected tissue).

Alternatively, this may be associated with congenital anomaly, in which case blind-ending blood vessels are seen in the vas deferens (the tube which normally carries sperm).




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