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Urology  (Expert Forum)
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Undecended testi and infertility.
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Undecended testi and infertility.

by Tim, Nov 29, 1999 12:00AM
Hi,
I am a 22 year old male from England. When I was 18 months old
I had a hernia operation on my left side. Both my testicles
were undecended at this age. When they operated for my hernia
they also brought down my left testi into the scrotum. My right
testicle was still undecended at the age of 9 and I went to
hospital to have this lowered. I did go into surgeory but
the doctors decided not to do anything and let nature take its course. My right testi is now in the scrotum (I cannot remember
when it came down) but much smaller and higher than the left.
I also had Mumps shortly before my hernia operation, what are the statistics to say I am now infertile or sterile? My left testicle
does seem to be healthy and I produce the average amount of semen
(although slightly yellow in colour).
I am concidering a sperm count from a clinic but I am not sure
how I would cope if I was told I would never have children. If
I were to go through with this and was told I was infertile, what
cures/remedies are available? Would this be easier or harder to treat in someone of my age?
It is also very frustrating having my right testi smaller and
higher than my left, is there any surgeory available to correct this? If so is it safe, is it simple and would it effect fertilty?

                 thankyou for your time
                         regards
                             Tim

by hfhs M.D.-AK, Nov 30, 1999 12:00AM
Dear Tim,
Undescended testicles is one of the most common birth defects in the United States.  It occurs in as many as 3-5% of boys at birth.  Undescended testis is more common in prematurely born boys and may also run in families.  More than not, the testis make their way into the scrotum after a year.  After this time period, the chance of descent is minimal and often surgery is recommended.  This seems like the scenario that you were involved with.  The right testis may have been thought to be retractile and not operated on.
Your question primarily stems from a fertility standpoint.  After about one year of age, a testicle that is not down will start to lose some of its fertility.  This is due to heat exposure from the testis being so close to the body.  If the testis remain undescended , it may lose its ability to make sperm at all.  Although most boys with one undescended testicle are able to have children (paternity rate 65-80%), many with bilateral undescended testis have more fertility problems (paternity rate 50-60%).
The reasons to bring a testis into the scrotum are to improve its sperm making potential, to achieve a normal appearance, to reduce the risk of a hernia, and to be able to examine it.  At your age, I don’t know the advantages of an operation outweigh the risks.  If you are worried about a cosmetic look, there are options, but I would consider the risks before deciding on surgery.
I don’t have the ability to examine you, but think an operation is probably  not  worthwhile.  If you are concerned with your sperm count, have it measured.  After all, you may not have a problem at all.
Your age would have no impact bad or good when talking about surgery.  However, at this age, if there is damage, the damage has already been done.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).


Sincerely,
HFHS M.D.-AK
*keyword: Undescended Testis
Member Comments (6)

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