Undescended Testical

Posted by Bill M on July 10, 1999 at 09:29:21
Hello
  I'm a 44 year old male. In 1978 I was operated on for for an undescended testicle. The doctor could not bring the testicle down to the proper location.  When I asked him why he did not remove it, he said that it still produced hormones.
  I went in for a physical last week. My doctor suggested that I see a Urologist concerning my testicle. My orginal Urologist has retired, so I had to find a new one. To make a long story short, the new Urologist suggested that I should have the right testicle removed. He said that it could cause major health problems, cancer being one of those. My original Urologist told me that once your reached the age of 37+ the risk of cancer was considerbly lower. The new doctor is saying that is not really true. I have no problems or symtoms (symptoms) of cancer. Should I leave well enough alone, or consider the removal of my right testical? If I do have it removed what is going to happen to my hormone level, and what else should I be concerned with? Do I still run a high risk if cancer at 44 years of age?
Thank You Very Much
Bill

Posted by HFHS M.D.-AK on July 14, 1999 at 13:45:01
Dear Bill,
The three main  reasons for relocating the testis are to provide an environment favoring normal organ maturity, the accessibility for self examination later in life, and the psychologic advantage of a normal full scrotum.  At age 44, the major concern is the accessibility of the testis for self evaluation.
It has been well established that undescended testicles are more likely to form cancer than testicles that have descended.  About 10% of all testicular cancers arise from cryptorchid testes.  The undescended testis is reported to be 35-48 times more likely to undergo malignant degeneration and abdominal testes even are 4 times greater.  Despite these numbers, at times,  testes are left in place even when they are unable to be brought into the scrotum to allow for puberty and the growth of secondary sexual characteristics.  The age that your original urologist talks about, is not necessarily an age when the chances of cancer drops, but rather an age when the risks of surgery and possible morbidity of that procedure, outweighs the risk of having testicular cancer.  I