{"id":1677,"date":"2021-07-06T11:23:26","date_gmt":"2021-07-06T08:23:26","guid":{"rendered":"https:\/\/dregemeneroglu.com\/inmemis-testisli-hastayi-nasil-degerlendiriyoruz\/"},"modified":"2021-07-06T11:30:00","modified_gmt":"2021-07-06T08:30:00","slug":"inmemis-testisli-hastayi-nasil-degerlendiriyoruz","status":"publish","type":"post","link":"https:\/\/dregemeneroglu.com\/en\/inmemis-testisli-hastayi-nasil-degerlendiriyoruz\/","title":{"rendered":"How do we evaluate the patient with undescended testis?"},"content":{"rendered":"
In the last journey, I explained what an undescended testis is and what problems it can cause<\/a><\/strong><\/span>.\u00a0\u00a0In this section of the pediatric surgeon’s journal, I will explain how a patient with an undescended testis was evaluated.<\/span><\/h5>\n
As doctors, we first listen the story with details which means we take anamnesis.\u00a0\u00a0If our patient with undescended testicles is a small baby, we question whether there is an endocrine disorder during pregnancy, that is, whether the mother used hormone medication.\u00a0\u00a0We are investigating unexpected loss of newborns, genital abnormalities, infertility in the family to reveal a concomitant genetic problem.\u00a0\u00a0If our patient is a little older, we learn whether the testicles were in the sack when he was born or whether he has had an inguinal surgery such as a hernia before.\u00a0\u00a0All of these can push us to investigate in different ways.<\/span><\/h5>\n
\u00a0After taking a good anamnesis, it’s time for the examination.\u00a0\u00a0Sometimes parents ask what we saw in the two-minute exam.<\/span><\/h5>\n
\u00a0Let me tell.<\/span><\/h5>\n
First, we look for clues to possible hormonal, genetic, and metabolic problems that are generally noticeable.\u00a0\u00a0Then we move on to the genital examination.\u00a0\u00a0Patience is very important in the examination of the undescended testis.\u00a0\u00a0A crying child can contract his abdominal muscles, pull up the testicles that are normally in his sack, and mislead us.\u00a0\u00a0Likewise, it is very important that the room, the place where the child sleeps, and our hands as they should not be cold.\u00a0<\/span><\/h5>\n
In the examination, we start from the inguinal canal with one hand and make a milking movement towards the sack and try to catch it in the bag with the other hand.\u00a0\u00a0With these maneuvers, we understand the location of the testis, its dimensions, its difference with the other testis, its hardness, whether its borders are smooth, that is, whether it contains a mass.<\/span><\/h5>\n
Sometimes the sack is empty during the examination, but we find the testis in the canal, when we milk it, it goes down into the sack, if its dimensions are good and we keep it in the sack for a while, we let him forget the cremaster reflex and if it stays in the bag when we let go, we say \u201cshy testis\u201d.\u00a0\u00a0Sometimes the testicle does not reach us at all.\u00a0\u00a0This is what we call “nonpalpable testis”.\u00a0\u00a0Let me describe these patients in a separate topic.\u00a0\u00a0Long explanation can be quite distracting.<\/span><\/h5>\n
Apart from the testis, we also examine the entire genital area.\u00a0\u00a0For example, the size of the penis, or the fact that the urinary hole that should be at the tip of the penis is lower, that is, the presence of hypospadias can give us clues about the sexual development disorders that can accompany us.\u00a0\u00a0Again, the fact that the sack is too small can give us the idea that the testicle does not descend or will not descend at all, or that the appearance of the structure of the bag is not normal can guide us in the direction of sexual development disorders.<\/span><\/h5>\n
We also look at the inguinal canal.\u00a0\u00a0I told you last time that inguinal hernia may accompany these children, and in addition, inguinal examination is indispensable to feel the lymph nodes in the groin and testicles in the groin.<\/span><\/h5>\n
Let’s move on to imaging techniques.<\/span><\/h5>\n
I can frankly state that no imaging technique can take precedence over physical examination and diagnostic surgery.\u00a0\u00a0The most commonly used imaging technique is ultrasonography, which works well for the nonpalpable testicles, which I will explain later.\u00a0\u00a0For example, we may not be able to feel the testicles in very obese children because of the adipose tissue.\u00a0\u00a0In this case, before looking with laparoscopy, performing ultrasonography and learning that the testicles are in the inguinal canal will change the surgical approach technique which is important.<\/span><\/h5>\n
We can also apply to find out the testicles dimensions while following the shy testicles.\u00a0\u00a0In fact, this is not a requirement either, but today, having a document for protecting ourselves within the understanding of “protective medicine” strengthens our hand.\u00a0\u00a0Otherwise, most of the time, our radiologist friends who do ultrasonography say that what they see is exactly the same as our examination findings.\u00a0\u00a0This is not due to a personal skill.\u00a0\u00a0We pediatric surgeons do so many genital examinations.\u00a0\u00a0So the important thing is our physical examination.<\/span><\/h5>\n
Do you know why I am telling you this?<\/span><\/h5>\n
Messages keep coming.\u00a0\u00a0This is the latest fashion.\u00a0\u00a0Parents are posting photos, “should there be surgery?”\u00a0\u00a0they ask.\u00a0\u00a0Or they send the ultrasound result, the report says the testis is in the inguinal canal.\u00a0\u00a0However, even in a normal child, a normal testicle may appear above the scrotum with the contact of the cold gel while ultrasound is being performed.\u00a0\u00a0How can we decide what to do by looking at a photograph or an ultrasound report?<\/span><\/h5>\n
Well, we finally decided that it was an undescended testis.\u00a0\u00a0What will happen?<\/span><\/h5>\n
In newborn babies, the descent journey may continue for another 4-6 months.\u00a0\u00a0We will wait patiently with the risk of possible inguinal hernia and testicular rotation, that is, testicular torsion.\u00a0\u00a0It is accepted that if it does not go down until 4 months, it will not go down anymore.<\/span><\/h5>\n
If the testis has not descended, there is a risk of torsion which means there is a risk of rotation of the testis,there is a risk of hernia, there is a risk of cancer, there is a risk of trauma, there is a risk of decreased reproduction.<\/span><\/h5>\n
I burned your brain, didn’t I?\u00a0\u00a0Let’s answer the question that is the title of our blog: How do we evaluate the patient with undescended testicles?\u00a0\u00a0Answer: By physical examination<\/span><\/h5>\n
In the end, we decided on the undescended testis.\u00a0\u00a0How will we treat it?\u00a0\u00a0When will we treat it?<\/span><\/h5>\n
I will explain the type and timing of undescended testis treatment in the next course, and the nonpalpable testis in another course.<\/span><\/h5>\n
Please click if you want to see the youtube video<\/span><\/strong><\/span><\/a>, follow us on instagram<\/span><\/strong><\/span><\/a>.<\/span><\/h5>\n
<\/h5>\n
\u00a0And stay happy.<\/span><\/h5>\n
<\/h5>\n
Prof. Dr. Egemen Ero\u011flu<\/span><\/h5>\n
<\/h5>\n
<\/h5>\n","protected":false},"excerpt":{"rendered":"

In the last journey, I explained what an undescended testis is and what problems it can cause.\u00a0\u00a0In this section of the pediatric surgeon’s journal, I will explain how a patient with an undescended testis was evaluated. As doctors, we first listen the story with details which means we take anamnesis.\u00a0\u00a0If our patient with undescended testicles […]<\/p>\n","protected":false},"author":2,"featured_media":1645,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[],"class_list":["post-1677","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-en"],"yoast_head":"\nHow do we evaluate the patient with undescended testis? - Prof. Dr. Egemen Ero\u011flu<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dregemeneroglu.com\/en\/inmemis-testisli-hastayi-nasil-degerlendiriyoruz\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How do we evaluate the patient with undescended testis? - Prof. Dr. Egemen Ero\u011flu\" \/>\n<meta property=\"og:description\" content=\"In the last journey, I explained what an undescended testis is and what problems it can cause.\u00a0\u00a0In this section of the pediatric surgeon’s journal, I will explain how a patient with an undescended testis was evaluated. As doctors, we first listen the story with details which means we take anamnesis.\u00a0\u00a0If our patient with undescended testicles […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/dregemeneroglu.com\/en\/inmemis-testisli-hastayi-nasil-degerlendiriyoruz\/\" \/>\n<meta property=\"og:site_name\" content=\"Prof. Dr. Egemen Ero\u011flu\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/egemen.eroglu.750\" \/>\n<meta property=\"article:published_time\" content=\"2021-07-06T08:23:26+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-07-06T08:30:00+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/dregemeneroglu.com\/wp-content\/uploads\/2021\/05\/4-908x1024.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"908\" \/>\n\t<meta property=\"og:image:height\" content=\"1024\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Egemen Ero\u011flu\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Egemen Ero\u011flu\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/dregemeneroglu.com\\\/en\\\/inmemis-testisli-hastayi-nasil-degerlendiriyoruz\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/dregemeneroglu.com\\\/en\\\/inmemis-testisli-hastayi-nasil-degerlendiriyoruz\\\/\"},\"author\":{\"name\":\"Egemen Ero\u011flu\",\"@id\":\"https:\\\/\\\/dregemeneroglu.com\\\/#\\\/schema\\\/person\\\/280787af17547a27921fa0839bcb0a45\"},\"headline\":\"How do we evaluate the patient with undescended testis?\",\"datePublished\":\"2021-07-06T08:23:26+00:00\",\"dateModified\":\"2021-07-06T08:30:00+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/dregemeneroglu.com\\\/en\\\/inmemis-testisli-hastayi-nasil-degerlendiriyoruz\\\/\"},\"wordCount\":1025,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/dregemeneroglu.com\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/dregemeneroglu.com\\\/en\\\/inmemis-testisli-hastayi-nasil-degerlendiriyoruz\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/dregemeneroglu.com\\\/wp-content\\\/uploads\\\/2021\\\/05\\\/4-scaled.jpg\",\"articleSection\":[\"Blog\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/dregemeneroglu.com\\\/en\\\/inmemis-testisli-hastayi-nasil-degerlendiriyoruz\\\/\",\"url\":\"https:\\\/\\\/dregemeneroglu.com\\\/en\\\/inmemis-testisli-hastayi-nasil-degerlendiriyoruz\\\/\",\"name\":\"How do we evaluate the patient with undescended testis? 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