21-year-old Max Schuller was an avid biker. He noticed some enlargement in his right testicle after his last century ride but attributed the swelling to the 100 miles spent on his bike. He continued to train the following week and noticed that the swelling was not decreasing. Upon physical examination, he could feel a small mass in his right testicle. At that point, he made an appointment with his family physician.
He explained to his physician that there was no pain or tenderness in the testis but the swelling would not go away. Upon examining his medical charts, the physician noted that Max had undergone an orchiopexy at 12 months of age for an undescended testicle (cryptorchidism). See also undescended testicle.
View Orchiopexy to Correct Undescended Testicle video (This link will take you directly to the YouTube video)
The testicles develop in the abdomen. They should move down, through the inguinal canal, into the scrotum between 28-40 weeks of gestation. Undescended testicles may not cause pain but may lead to abdominal swelling. If this condition is not corrected, infertility may occur. The risk for testicular cancer increases, even if orchiopexy is performed. Under the link for orchiopexy, click on "undescended testicle" for a picture of the pathway of testicular descent.
- 1. What is an orchiopexy?
- 2. What does cryptorchidism mean?
- 3. What percent of premature infant boys are born with at least one undescended testis? What percent of full-term infant boys are born with at least one undescended testis? What percent of undescended testes descend by the first year of life?
- 4. What risks are associated with undescended testes?
Max's doctor told him he suspected he may have testicular cancer, because of the swelling and the palpable mass. He referred Max to an oncologist for further testing.
On physical examination, the oncologist noted a firm mass, about 4 cm in diameter, in the right testicle. The epididymis appeared normal in size. The left testicle also appeared normal. The oncologist ordered an ultrasound which is used to confirm the mass and rule out swelling due to a hydrocele or varicocele.
Make sure to click on the picture of the hydrocele under the hydrocele link.
Click here for a picture of a transillumination test for a hydrocele.
- 5. What type of energy is used in an ultrasound?
- 6. What is a hydrocele?
- 7. Why is a hydrocele common in a newborn infant?
- 8. What is an easy test for a hydrocele?
- 9. What is a varicocele?
- 10. Click on the next page of the varicocele link to answer the following question: What age has a 15% incidence of varicoceles?