Undescended testis!

When undescended testis is mentioned, the testis that is hidden or intangible in the narrow sense comes to mind. A true undescended testis is when the testis stops at any point on the descent path, may also be outside the normal path, a condition called ectopic testis and is a rare condition.
Undescended testis is one of the most common congenital genitourinary anomalies. It is seen in 3% of those born at term and 30% of those born prematurely. In the first months of life, most of the undescended testicles descend into the bag spontaneously, but it decreases to about 0.8-1% until the age of 1 year. Regarding the undescended testis, there is the patent processus vaginalis, which prepares the ground for the formation of hydrocele and hernia.
Men with a history of undescended testicles are at risk of developing infertility and testicular cancer. While the risk of infertility is low in patients with unilateral undescended testis, 50-70% infertility is in question in those with a history of bilateral undescended testicles. Undescended testis operations performed in the first 6-12 months in the early period contribute positively to infertility.
The risk of testicular cancer in men with undescended testicles increases 5-10 times compared to the general population. This rate is higher in testicles located in the abdomen than in testicles located in the inguinal canal. There is no definitive proof that this risk is reduced after surgery, but because the testis is easier to palpate, a possible cancer will be diagnosed earlier, thus enabling early diagnosis.
Undescended testis is called the entrapment of the testis during its normal descent. Undescended testis is usually palpable in the groin. If bilateral undescended testicles are not palpable, they are mostly located in the abdomen and a stimulating test should be performed on them. Various radiological methods are used in the evaluation of the undescended testis.
The diagnosis of undescended testis is based on physical examination. Absence of testis in USG, CT and MRI cannot guarantee the absence of testis and in this case, that area should be investigated surgically.
If there is a picture called hypospadias or ambigus genital with bilateral undescended testis, it may present a life-threatening feature. In this case, endocrinological evaluation is required.
Treatment should be started before 1 year of age. Surgical treatment is the gold standard treatment, but hormonal treatment can be applied in some cases. Laparoscopy can be performed in patients with intra-abdominal placement.

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