Undescended Testis and Hydrocele in Baby Boys: A Parent Guide (Video)

Transcript

Your newborn's testicle hasn't dropped yet, how worried should you be?

Your newborn's testicle hasn't dropped yet, how worried should you be?

Baby Boys' Swollen Groin

Stay for the one mistake parents make with a baby's swollen groin.

What's happening down there

Here's the thing. An undescended testis means one or both testicles haven't finished moving down into the scrotum. Many come down on their own in the first few months. A hydrocele is a soft, fluid swelling around the testicle, like a little water balloon, and it's common in newborns too. Neither is an emergency. Only a hard, painful swelling is.

Checking at home

The hospital checks your baby's testicles at birth, and you can ask again at vaccination visits. At home, timing is everything. Cold makes those little testicles pull up, so pick a warm room, bath time or straight after. Lay him on his back, legs relaxed and slightly apart, like a frog. Look first, are both sides filled? Then with warm fingers, run one finger gently from the groin down.

Warm bath, not cold room

This is where it gets interesting. If you can feel the testicle in a warm bath but not after a nappy change on a cold morning, that points towards a retractile testis. That's a normal testicle that pulls up when cold or touched, usually nothing to worry about. Tell the doctor exactly when you felt it and when you didn't. That detail helps more than a chilly clinic exam.

Six months: the checkpoint

Now, the part most people miss. Testicles start inside the tummy and travel down late in pregnancy, so boys born early are more likely to have one that hasn't finished the trip. Most arrive within the first twelve weeks, and by six months, nearly all that are going to come down have done so. After that, they rarely come down on their own. A testicle that stays up is warmer than it should be. Six months is the checkpoint.

Surgery around one year

If it's still not down by six months, surgery is the usual next step around the first birthday. It's called an orchidopexy. A paediatric surgeon brings the testicle down and fixes it in the scrotum, through small cuts in the groin and scrotum, under general anaesthetic. Most babies go home the same day. If it can't be felt at all, the surgeon may use keyhole surgery to look inside the tummy.

Retractile testis

Some boys have a strong muscle reflex that pulls a normal testicle up into the groin when they're cold, ticklish, or being examined. The good news is it can be gently brought back down, and it stays for a while. That's a retractile testis, and it usually settles at puberty. It doesn't need surgery, though doctors like to check it yearly. If you've felt it at home but the doctor can't find it, tell them what you felt.

Hydrocele: water balloon

A hydrocele is fluid around the testicle inside the scrotum, so one side looks larger and feels soft, like a small water balloon. It's common in newborns and usually painless, and most go away within the first year. But here's the tricky part. Some hydroceles are connected to the tummy through a channel that didn't close. If the swelling gets bigger by the evening or when the baby cries, mention it, because it can be linked to a hernia.

Inguinal hernia

An inguinal hernia is different. It's a bulge in the groin or scrotum where a loop of bowel slips through. It often appears when the baby cries or strains, and disappears when he's calm. Hernias in babies are repaired by surgery soon after diagnosis, because of the risk of the bowel getting stuck. If you see a bulge that comes and goes with crying, get it checked.

Go to hospital now

Here's the part where you don't wait. Go to hospital now if the swelling becomes hard, tender, red or blue, or doesn't go down when the baby is calm. Also if he's crying inconsolably, vomiting, especially green, or not feeding. Sudden pain or swelling of a testicle in any boy, at any age, is an emergency, because it can be twisting, what doctors call torsion. Don't massage, bind, or apply heat or oil.

Khatna and other questions

Many Pakistani families plan khatna, circumcision, in the first weeks or months. If your son has an undescended testis, hydrocele, or hernia, tell the doctor doing the khatna. Sometimes the surgeon prefers to do both under one anaesthetic later, sometimes the khatna goes ahead first. It's a joint decision. Malish is fine for the body, but keep oil and pressure away from a swollen groin. Pushing on a hernia or hydrocele is never a good idea.

The one mistake to avoid

So here's the one mistake I promised earlier. Pushing on a hernia or hydrocele to settle it. Some parents, with love in their hearts, press or massage a swollen groin hoping to push it back. Please don't. That can make things worse, and it's exactly what turns a manageable situation into an emergency. No massage, no binding, no heat, no oil on that area. Leave it alone and let a doctor decide.

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Read the full guide

The full guide is on thecareonline.com. General information only, so check with your doctor for your own case.