Surgical treatment of undescended testicle (Anomalies in the position of testicles)
It is referred with several denominations: Chirporquidism, undescended testes, ectopic testes.
The human species is almost unique in the fact that male newborns have descended testes since birth. Anomalies in the descent or position of the gonads can cause atrophy and more prevalence of malignant neoplasms.
It is therefore very important to detect as soon as possible anomalies in the position of the testicles and if necessary, provide effective surgical treatment.
The main variants are:
• Migratory testes
• Retractile testes
• Undescended testes. In this variation the testes can be intra-abdominal or located in the inguinal canal or in ectopic sites.
All types of abnormally located testicles, except the ones classified as migrant, need surgical treatment ideally prior or at 1 year of age.
This increases the possibility of a normal development and locates the testes in a more accessible position.
Depending on the anatomical location, the treatment can be done by laparoscopy or by open technique.
To design the best diagnostic route, it is of the outmost importance the opinion of an experienced pediatric surgeon.
It is a congenital anatomical anomaly. More frequent in males than females and the surgical treatment is relatively simple and the potential complications of not treating them can be catastrophic.
It is customary knowledge in pediatric surgery that inguinal hernias, which are indirect in 99% of children, have to be operated on as soon as they are suspected or diagnosed to avoid complications.
Surgery is a day case and is performed with a short general anesthesia.
It is common at birth, as it is the point where the umbilical cord and its vascular components are connected to the placenta. After birth, it normally heals and suffers an involution, but it can leave a defect sometimes as big a 2 cms. in diameter. It is usually benign and resolves spontaneously in the first two years of life.
It is more common in females and in some human groups, but if it doesn´t close at 2 years of age, it requires surgical correction.
It is done as a day case, with a short general anesthesia.
Varicocele is more common on the left side and it can be bilateral. Consist of varicosities of the veins of the spermatic cord and is associated with infertility if not treated. The gold standard nowadays is high ligation of the vascular pack of the testes by laparoscopy.
It has as good results and number of side effects as the many surgical techniques performed years ago, but it is less painful, and performed with direct magnified vision of the vessels.
It is a day case, with a short general anesthesia.
Anomalies of the prepuce (phimosis)
Most male babies are born with the glans covered by the very special kind of skin called prepuce. In some cultures, the prepuce is removed for religious or hygienic consideration. Today most pediatric surgeons and urologist agree that surgical intervention of the prepuce with circumcision or prepuceplasty, should be done only if there is fibrosis due to scarring of the prepuce.
There have been many discussions and disagreements about this subject, but in modern pediatric care, circumcision is generally not done as a routine.
If the clinician diagnoses a phimosis, then 2 procedures can be done:
• Circumcision, which is the surgical ablation of the prepuce
• Prepuceplasty, which is opening the scarred tissue of prepuce, and through a dorsal slit in the skin, correction of the constricting ring of the scarred prepuce, suturing this incision in a transversal direction
Both procedures must be done with a general anesthesia except in newborns in whom we can do it with local anesthesia
They are always day cases and should be performed by an experienced pediatric surgeon.
Common congenital anomaly consisting of a short tongue frenulum. That causes difficulty for a normal speech. This is very important for the normal development of children.
The procedure is done with a short sedation and local anesthesia and three or four stitches to correct the resulting wound after cutting the frenulum. It is also a day case and with very little discomfort for the child.
*Prices can vary without prior notice. The patient understands that every medical procedure comes with an inherent risk, any complication during the surgery may generate additional costs. Expenses considering day ambulatory surgery.
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