NYAHURURU, Kenya — Urologists practicing in Nyahururu town have expressed significant concern regarding the elevated incidence of undescended testis among children in Nyandarua and Laikipia Counties.
Medical examinations are frequently revealing this condition in young patients, often unbeknownst to their parents.
Drs. Priscila Maina and Dismas Kazimoto contend that the prevalence of these cases in the area is notably higher compared to other regions.
Dr. Maina elucidated the condition, stating, “This is when testes are not in the scrotum sack. It happens because the testes are initially formed in the abdomen. Then when the baby grows in their mother’s womb, they go down to the scrotum sack.”
She explained that an undescended testis can typically become lodged in the upper, middle, or lower abdomen, or within the inguinal canal.
The doctors highlighted an increasing trend, noting that hardly a week passes without such cases being reported at local health facilities.
“We had many cases of undescended testis in children. It is a concern to us because it has been noted that Nyandarua and Laikipia counties have the highest prevalence of undescended testis in Kenya,” Dr. Maina added, underscoring the regional concentration of the issue.
These concerns were voiced during a free medical camp organized for patients with hernia and undescended testis at Nyahururu’s Pearl Hospital.
Dr. Kazimoto indicated that undescended testis is commonly associated with premature birth, though he acknowledged that other potential causes are still under investigation.
Dr. Maina echoed his sentiments, issuing a stern warning about the potential consequences of leaving the condition untreated.
She stated that untreated undescended testis carries the risk of developing testicular cancer and can also cause psychological trauma to the child.
She emphasized the importance of early intervention, advising that a child should receive treatment before reaching the age of two.
Dr. Maina urged mothers to routinely palpate the testicular area while bathing their child to ascertain the exact position of the testes.
What is cryptorchidism (undescended testes)?
Cryptorchidism, commonly known as undescended testes, is a medical condition observed in newborn males where one or both testes have not descended into the scrotal sac. This occurs bilaterally (affecting both testes) in approximately ten percent of cases.
Cryptorchidism is more frequently diagnosed in premature male infants, as testicular descent from the abdomen to the scrotal sac typically concludes during the seventh month of fetal development.
What causes undescended testes?
The occurrence of undescended testes can be attributed to several factors.
While prematurity is a primary cause, other contributing factors may include hormonal disorders, spina bifida, retractile testes (a reflex where a testicle moves back and forth between the scrotum and groin), or, in rare instances, testicular absence.
Who is affected by undescended testes?
According to pediatric urologists, undescended testes affect approximately 3 to 5 percent of all male infants. The prevalence is higher among premature male infants, with up to one-third experiencing the condition.
There is also a notable genetic predisposition, as 14 percent of males with undescended testes have a male relative who also had the condition.
Undescended testis is also commonly associated with an Inguinal Hernia on the same side.
Identifying symptoms of undescended testes
The most common symptom of cryptorchidism is a nonpalpable testis, meaning the testicle cannot be felt upon examination. However, the manifestation of symptoms can vary among individual children.
It is important to note that symptoms of cryptorchidism may resemble other conditions or medical problems; therefore, it is crucial to always consult a child’s doctor for an accurate diagnosis.
Treatment and management of undescended testes
In many cases, undescended testes resolve spontaneously.
Three-quarters of cases typically resolve by 3 months of age, and 99 percent resolve by one year without any medical intervention.
This resolution occurs as the testicles descend from the inguinal canal (a small internal passageway located near the groin in the abdomen) into the scrotal sac.
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Specific treatment approaches for undescended testes are determined by a child’s doctor, taking into account:
- The child’s age, overall health, and medical history
- The severity and extent of the condition
- The child’s tolerance for specific medications, procedures, or therapies
- Expectations regarding the course of the condition
- Parental opinion or preference
Treatment options may include:
- Hormonal therapy: The administration of certain hormones may stimulate testosterone production, which can aid in the descent of the testes into the scrotal sac. However, this method is not routinely employed for truly undescended testes.
- Surgical repair (Orchiopexy): A surgical procedure to locate the undescended testicle and bring it down into the scrotal sac may be recommended. This surgery, known as orchiopexy, is typically performed between 6 and 18 months of age and boasts a success rate of 98 percent in children with this condition.
If cryptorchidism is left unrepaired, several potential complications may arise as a child grows and matures. These include:
- Infertility: This is a significant concern, particularly in bilateral cases where both testes are affected.
- Increased risk of testicular cancer: The risk of developing testicular cancer rises considerably by age 30 or 40 if the condition is not corrected.
- Inguinal hernia: A weakened area in the lower abdominal wall or inguinal canal through which intestines may protrude.
- Testicular torsion: A painful twisting of the testes that can compromise blood supply to the organ.
- Psychological consequences: An empty scrotum can lead to significant psychological distress in the affected individual.
Patients and parents are strongly advised to consult their doctor with any questions or concerns regarding this condition.
