​What kinds of symptoms do patients experience before receiving treatment?

Normally, before a baby boy is born, the testicles move into the scrotum (the sac that holds the testicles). Sometimes, one or both testicles stay in the body cavity instead of moving into the scrotum. This is called undescended testicles or cryptorchidism. An orchidopexy is an operation to lower the testicles into the scrotum. A patient may need to have this operation on one or both testicles.

​What is the impact on patients’ lives of living with these conditions?

Ideally, the surgery should be performed before a child reaches two years old. Left untreated, this condition can lead to infertility. The higher temperature inside the body can affect sperm production. Men with both testicles affected are more likely to experience fertility-related issues than men with only one affected testicle. This condition can also cause inguinal hernia, in which the intestine protrudes through a weakened area in the abdominal wall. Only surgery can correct this condition, which can otherwise result in intestinal damage or death. Finally, this condition is a risk factor for testicular cancer. If surgery is performed early, this risk is limited.

What cultural or regional factors affect the treatment of these conditions?

Undescended testis is the most common birth anomaly in boys. This condition is present in about 1-4.5% of newborns, with a higher incidence in premature babies (30-45%). Unilateral undescended testis is four times more likely than bilateral.

What does the treatment process look like?

After surgery, the patient will stay in the hospital for an average of three days. The patient is continually monitored.

What is the impact of this treatment on the patient’s life?

Treatment will reduce the risk of infertility, inguinal hernia, and testicular cancer.

What potential side effects or risks come with this treatment?

This condition is very treatable, and the procedure is low-risk.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

There are few quality care centers in the region. Hospitals lack adequate resources and expertise to treat this condition.

What are the alternatives to this treatment?

An alternative to surgery is to use synthetic hormones that encourage the testicle to move into the scrotum. Hormone therapy is only recommended if the child’s testicle(s) are close to the scrotum. However, hormone therapy is not commonly available in Kenya. According to the guidelines published by the American Urological Association in May 2014, orchidopexy is the most successful therapy to relocate the testis into the scrotum. Hormone therapy is not recommended.