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Multicystic dysplastic kidney

The malformation of the kidney during the fetal development is called Multicystic Dysplastic Kidney (MCDK). It consists of irregular cysts of varying sizes. It occurs more frequently in boys than girls and is thought to affect 1 in every 3,500 people and is most common is Caucasian background. MCDK is a cause of abdominal mass in infants and is a common type of renal cystic disease. MCDK does not require any specific treatment. Over time abnormal kidney regresses and goes away. 

Conditions sometimes associated with MCDK may include 

  • Vesicoureteral reflux 
  • Uretero-pelvic junction obstruction 
  • Ureterovesical junction obstruction 

Polycystic kidney disease 

Polycystic kidney disease (PKD) is an inherited disorder in which clusters of cysts develop primarily within your kidneys, causing your kidneys to enlarge and lose function over time. Cysts are noncancerous round sacs containing fluid. The cysts vary in size, and they can grow very large. Polycystic kidney disease (PKD) is a genetic disease. This means that it is caused by a problem with your genes. PKD causes cysts to grow inside the kidneys. These cysts make the kidneys much larger than they should be and damage the tissue that the kidneys are made of.

Symptoms may include  

  • High blood pressure 
  • Blood in urine 
  • Lump in the abdomen 
  • Pain in the abdomen or back 
  • Fatigue syndrome and features of Renal Failure
  • Irreversible kidney damage 

There is no certain cure for polycystic kidney. It can be also associated with urinary tract infection, kidney stone or a malignancy. Treatment includes medication to control blood pressure and pain relievers. A kidney transplant may eventually be required 

Cryptorchidism

The undescended testis which does not reach the scrotum during the development of a fetus. It is one of the most common genital condition that doctors can identify during childbirth. It sometimes corrects itself after a few months of birth, however many a times, surgery is required to relocate testicles back to the scrotum. 

Older boys — from infants to pre-adolescent boys — who have normally descended testicles at birth might appear to be “missing” a testicle later. This condition might indicate:

  • A retractile testicle, which moves back and forth between the scrotum and the groin and might be easily guided by hand into the scrotum during a physical examination. This is not abnormal; it is due to muscle reflex in the scrotum.
  • An ascending testicle or acquired undescended testicle, that has returned back to the groin and cannot be easily guided back to the scrotum.

Can adults have Undescended testicles?

Yes, but it is exceedingly rare. For those who receive routine healthcare and checkup it usually found and repaired in childhood, However, an undescended testicle or testicles can occur in someone who did not receive the appropriate diagnosis and treatment during childhood. 

Common symptoms –

Undescended testicles may be palpable or nonpalpable. 
Palpable means that the doctor will be able to feel the undescended testicle during a physical examination 

Nonpalpable means it cannot be felt by hands but may be seen sometimes(around 40% cases) in ultrasound/MRI abdomen and it may be:

  • Inguinal/Proximal to inguinal region: The testicles have reached into the inguinal canal or just at its entrance. But not far enough to be detected by touch.
  • Abdominal: The least common location for undescended testicles in the abdomen. 
  • Atrophic or absent: The testicle is exceedingly small or has never been formed. 

Risk factors –

The following risk factors may increase the risk of cryptorchidism 

  • Premature birth 
  • A low birth weights
  • A family history of issues with genital development 

Diagnosis –

Physical Examination: In case of palpable testis, can be examined and diagnosed with Physical examination

If the testicle is nonpalpable, an ultrasound scan/ MRI can often show its location 

Diagnostic Laparoscopy: A doctor inserts a tiny tube with an attached camera through a small incision in the abdomen and look for the testis. This is usually clubbed with the definite treatment for the procedure rather than just a diagnostic modality

Treatment –

Treating an undescended testicle when your son is still a baby might lower the risk of complications later in life like infertility and testicular cancer. 

Treatment includes surgery to bring testis down in the scrotum as a single stage surgery or in two stage surgery.

In cases with delayed detection (especially in late childhood/Adolescence/Adulthood), testis might get atrophic and sometimes require to be removed(orchidectomy)

If you notice any changes in your son’s genitals or are concerned about his development, talk to the urologist.