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Undescended Testicles

Our 4-year-old son with CdLS weighs approximately 17 pounds. At the age of three weeks he required surgery to remove an inguinal hernia. At that time the surgeon discovered only one testicle in his abdomen; the other testicle could not be detected. He was placed on HCG-hormone injection three weeks ago to see if this would lower his testicles. If this is not successful, is surgery the only other option?

The management of your son's undescended testicles (a relatively common finding in CdLS) sounds very appropriate so far. It is standard treatment to give HCG hormone injections to stimulate descent of the testicles initially. It sounds to me as if the testicles are now in the area called the inguinal canal, or the area where the legs meet the pelvis. This is an area where the testicles can be damaged by trauma or predisposed to twisting on themselves if left there. It would be medically recommended for your son now to undergo surgery (orchidopexy) that brings the testicles into the scrotum. It is my understanding that once the testicles have come into the inguinal region, further hormone treatment will not bring them down any lower and might even damage some of the testicular tissue. So I would agree with the surgery at this point.

TK 7-13-10



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