Testicles enter the inguinal groove

The testicles enter the inguinal groove, which is a more obvious manifestation of cryptorchidism. Cryptorchidism is not common, but once it occurs, it will have a great impact on men, the biggest impact of which is that it will affect men's normal sexual function and fertility. Cryptorchidism can be treated in many ways, such as hormone therapy and surgical treatment. Below, we will introduce you to the knowledge of cryptorchidism treatment!

1. Best time for treatment

The ideal age to preserve fertility is 12 to 24 months after birth. Spontaneous testicular descent can be completed within 3 months after birth. Definitive treatment of undescended testicles should be completed between 6 and 12 months after birth, which is the best time to perform testicular descent fixation.

2. Hormone therapy

Cryptorchidism may be associated with hypothalamic-pituitary-gonadal axis abnormalities, and hormone therapy uses HCG, LHRH, or a combination of both. The guidelines recommend β-HCG for preoperative preparation in cases of inaccessible cryptorchidism or some reoperation cases, which can increase testicular blood supply and facilitate surgery.

3. Surgical treatment

For those whose testicles have not descended into the scrotum after 6 months of birth, surgery should be performed as soon as possible. For adolescent patients with cryptorchidism, testicular descent and fixation should be performed as soon as it is discovered. If the testicles are found to be atrophic or unable to descend into the scrotum during the operation, orchiectomy can be performed if necessary.

(1) Open surgery for testicular descent fixation

For patients with palpable occult testicles, testicular descent fixation is performed. Generally, the approach is through the inguinal groove, an oblique incision is made in the inguinal groove, the spermatic cord is freed, the unclosed processus vaginalis or hernia sac is ligated, and the testicle is placed and fixed in the scrotum without tension.

(2) Laparoscopic surgery

Indications: All inaccessible testicles; diagnosis of suspected intercourse; biopsy or intraperitoneal high-positioned testicle removal. Contraindications: Acute infection, coagulation abnormalities, history of previous abdominal surgery, suspected peritoneal adhesions.

(3) Autologous testicular transplantation

Applicable to high-positioned cryptic testis. Ligate the testicular blood vessels, move the testicles freely into the scrotum, and anastomose the testicular blood vessels with the inferior epigastric artery. This is not a widely used method and is not recommended as a routine surgical method.