Hydrocele

During fetal development, testicles descend from the kidneys to the scrotum through the inguinal canal. Fluid accumulation around the testicle before closure can lead to a hydrocele. Many infant hydroceles resolve as fluid is absorbed and swelling diminishes. Surgery is unnecessary unless swelling fluctuates (indicating a hernia) or persists/worsens. Hydrocelectomy, done under anesthesia as day surgery, involves confirming no hernia via a camera inserted through the belly button, making a scrotal incision to drain fluid, and inverting the hydrocele sac to prevent recurrence.

Inguinal Hernia

During prenatal development, testicles migrate from the kidneys to the scrotum via the inguinal canal. An incompletely closed canal can lead to hernias, permitting abdominal fluid or intestines to enter the scrotum under pressure changes. While hernias are typically painless, parents may notice discomfort and varying scrotal size. Timely correction is vital to avoid complications like bowel strangulation, prompting urgent surgery. Symptoms of strangulation include red, swollen, firm scrotum, vomiting, or extreme fussiness. Surgical correction, done under general anesthesia as a day procedure, involves camera confirmation and groin incision closure. Subsequent camera assessment ensures effective closure.

Testicle Pain

Testicle pain can stem from various factors, ranging from benign causes that respond to rest and ibuprofen to those requiring antibiotics or urgent surgery. Sometimes, pain may have unclear origins, possibly related to nerve irritation, trauma, or common issues like constipation. Diagnosis involves a physical examination to assess conditions like hernia, hydrocele, testicular torsion, orchitis, or epididymitis. Scrotal ultrasound and urine analysis may be necessary. A thorough history, including sexual health, is essential. Based on findings, a diagnosis and management plan are formulated. For sudden pain or swelling, particularly if torsion is suspected, seek immediate ER care. For non-tender swelling, contact my office for evaluation.

Undescended Testicle

Before birth, testicles develop near the kidneys and gradually descend to the scrotum (the pouch of skin beneath the penis) via the inguinal canal in the groin. Sometimes, full descent doesn't occur naturally, leading to various positions, from the abdomen to the upper scrotum. While waiting is common, 90% should descend by one year; if not, surgical correction is advised. This is crucial because the scrotum provides the optimal environment for proper testicular growth. It also enables future self-exams for abnormalities. The procedure, orchidopexy, is done under general anesthesia as a day surgery. Different scenarios determine the surgical approach, including whether the testicle is palpable or not. In some cases, stages may be required for optimal results or, in rare cases, removal may be discussed with parents.