REVEALED:Males With Wrongly Positioned Testis Prone to Cancer – Urologist(Must For All Males+Remedies)

REVEALED:Males With Wrongly Positioned Testis Prone to Cancer – Urologist(Must For All Males)

Professor of Urology in the Faculty of Medicine, University of Calabar, Paul Ekwere, tells EMMANUEL OJO about the diagnosis and management of monorchidism; a condition that leaves a male with one testicle

What is monorchidism?

Monorchidism is the situation of having one testicle. That is just the definition. The situation of having just one testicle may be a result of several things.

What’s the normal number of testicles a male is required to have?

It is two. That’s the way the Lord made it.

Are there other possible situations where an individual can have more than two testicles?

Yes. Sometimes you have polyorchidism where a person can have a third testicle so that you find out that in one person, one side of the scrotum (the thin external sac under the penis which houses the testicle) may have two and the other side may have one but it is a very rare condition. It is extremely rare to have it that way.

How common is monorchisdism?

Monorchidism is even a rare condition whereby you have it only in about three to four per cent of all normal birth, which means that in about a hundred live babies that are being born, you find it in only three or four of them. So, out of every hundred boys, about three or four may have monorchidism.

What are the causes of monorchidism?

Well, the causes may be what we describe as congenital or it may be acquired. When we say congenital, it means that the child is born with that condition and when we say acquired, it means that something has happened, maybe to one testicle so that after the child has been born, he now ends up with one; so, there is a condition whereby during development, one testicle may disappear. This comes under the congenital category that I just mentioned. That is called ‘vanishing testis’ and it is caused by an intrauterine accident, injury, or assault when the foetus is still in the womb. That can happen and it is thought to be more of a vascular accident and the closest example we have to that is the distortion of the testes. When the testes are distorted, you find out that the blood supply to the testes is cut off as a result of the twisting of the cord. So, when the blood supply is cut off, the testicle just dies and vanishes, so that when a child is born, you will not see any testicle there.

Then the causes can be a result of the situation where the testis hasn’t descended.

Then the causes can be a result of the situation where the testis hasn’t descended. Maybe only one has descended into the scrotum during normal embryonic or foetal development. This condition is also called undescended testis or cryptorchidism.

The undescended testis may pass within the abdominal cavity, near the back while one descends into the scrotum and then you have a situation where the person has one visible testicle while the other one is still inside the abdomen or if it has tried to descend, it may be in the area described as the inguinal canal. In fact, that area is the commonest site for undescended testis. Technically, the person may have one testicle which I will now describe as one visible testicle because it’s the one that has descended whereas the other is still hidden in the abdomen or its track, trying to come down or what we call ‘ectopic position,’ which may be anywhere within the base of the penis, the groin or even the shaft of the penis itself. The testicle may be implanted in any of those places.

Apart from that, we have a condition in which one testicle has been surgically,

removed. That you may find in people who either have injury or malignancy, affecting one testicle, leading to surgical removal. On the other hand, the testicle may have suffered injury from trauma by either playing football or other games to the extent that it cannot be repaired. So, it will be removed and that will mean that the person in question will be seen with only one testicle, which is monorchidism.

Is there also a possible situation where a person will have no testicle?

Yes, like the one I just described; a situation where the testicle has not descended. That may sometimes be both sides. It can be both testicles not descended. In other words, they are trapped somewhere along the line so that they don’t enter the scrotum and how we got to know about that is that when you examine a baby, you find a scrotum that is described as hypoplastic; that is, it has not developed beyond a certain stage which means that no testicle has descended into that scrotum.

We must underline this with a situation where we have one or both testicles being retractile; we call that retractile testicle. There is something we call a ‘cremaster reflex’, that is if you stroke the side of the thigh of a baby, you will find out that the testicle reacts by going up. It just disappears. The difference between that and the undescended testis bilateral is that you find that the scrotum in this case has been well developed, meaning that testicle has entered that scrotum and it is not there only because it disappeared as a result of the cremasteric reflex that we spoke about. That is the difference. The difference is that in the other one, the testis has not entered the scrotum at all, not one. They are arrested in the abdomen or on their way out.

Are there risk factors that predispose one or a child to this situation?

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Males with wrongly positioned testis prone to cancer – Urologist