Chapter 31: Cryptorchidism (Children)

Question 1

Cryptorchidism

Answer 1

absent, undescended, or ectopic testicles

• may result from hormonal, anatomical, or chromosomal variations
• testicles are palpable but undescended, and the scrotal sac is empty as well as potentially flat or small

Question 2

The major Risk associated with Cryptochidism

Answer 2

testicular cancer, which remains a lifetime risk even if the child has surgical repair
-risk for decreased fertility, testicular torsion, and increased trauma

Question 3

What must patients do if they have a history of cryptorchidism

Answer 3

• vigilant with testicular self-exam

- have annual testicular exams

Question 4

When does the child receive surgical repair?

Answer 4

if the testis does not descend permanently by 6 months

Question 5

Signs and Symptoms

Answer 5

• a retractile testis has descended but retracts with exam and physical stimulation
• an ectopic testis is outside the normal pathway (e.g. in the groin, abdominal wall, or perineum)
• after 1 year of age, it is uncommon for the testes to spontaneously descend
• the undescended testicle is unilateral and on the right

Question 6

Diagnosis

Answer 6

-patient history, physical exam findings, and imaging tests

Question 7

Prevention

Answer 7

• risk of infertility may be decreased with surgical treatment
• risk of testicular cancer remains high throughout life

Question 8

Nursing Care

Answer 8

gentle compression of the inguinal canals should reveal a palpable nodule in the undescended testicles

• counsel parents about the surgery and the benefits of surgery for infertility
• be prepared to counsel parents about the emotional upset of increased lifelong risk of testicular cancer

Question 9

Surgical Care: Orchiopexy

Answer 9

• will receive general anesthesia and sometimes a caudal block prior to surgery
• done between 6 months to 12 months
• minimally invasive
• may involve laparoscope that is used to locate and pull down the undescended testicle into the scrotal sac, anchoring it there

Question 10

Education/Discharge

Answer 10

• applies to the patient who has undergone an orchiopexy surgery
• boys with this condition have a risk of infertility (but may be corrected with surgery) as well as testicular cancer

Question 11

Hydrocele

Answer 11

collection of fluid in the scrotal sac, r/t a patent processus vaginalis, which is the channel that gives fluid the ability to move from abdomen to groin

• peritoneal abdominal fluid can pass into this canal, enlarging the scrotal sac
• this canal is patent in the majority of all newborns at birth, and in the first month of life, the incidence decreases and decreases by the age of 18 to 24 months
• must be repaired if not resolved by 1 year