What should I do if my baby’s scrotum is small?

Many mothers have reported that when they found their baby’s scrotum was very small, they became worried that the baby might be sick. In fact, mothers don’t need to be too nervous. It may be that the child has not yet completed development, or it may be a temporary phenomenon. However, if the child has a small scrotum for a long time, it should be taken seriously. This means that your child may have a disease called cryptorchidism. Many people don’t know about it, so let’s learn about it together.

The testicles are initially formed inside the abdominal cavity and usually squeeze through the groin and into the scrotum before birth. The opening in the abdominal wall through which the testicles pass into the scrotum is usually closed, but sometimes this passage remains open, and fluid accumulates around the testicles, forming scrotal effusion. This swelling doesn't cause any problems for your baby and usually goes away on its own by the time your baby is one year old.

However, occasionally a small section of intestine will pass through this opening into the scrotum. This is called an inguinal hernia. A hydrocele is round and soft, whereas an inguinal hernia feels firmer, oval, and about the size of your thumb. It usually appears when the baby cries and retreats back into the belly when the baby is sleeping or relaxing. If this happens, you need to see a doctor and have a surgical repair.

There is also a situation where the intestines get stuck in the scrotum. If the lump gets bigger, harder, darker, and painful, or if your baby is vomiting and has stomach pain, see a doctor immediately for surgery to prevent damage to the intestines.

Patients with cryptorchidism without complications generally have no subjective symptoms. The main manifestations are flat scrotum on the affected side, asymmetry of the left and right scrotums in unilateral cases, and emptiness and deflation of the scrotums on both sides. If complicated by inguinal oblique hernia, a mass will appear on the affected side after activity, accompanied by distension and discomfort. In severe cases, paroxysmal abdominal pain, vomiting, and fever may occur. If the cryptorchidism is twisted, such as the cryptorchidism is located in the inguinal canal or external ring, the main manifestation is local painful mass, there is no normal testicle in the affected scrotum, and the gastrointestinal symptoms are mild. If the cryptorchidism is located in the abdomen, the pain site after twisting is in the lower abdomen near the internal ring. The symptoms and signs of right-sided intra-abdominal cryptorchidism torsion are quite similar to those of acute appendicitis. The main difference is that the tenderness point of intra-abdominal cryptorchidism torsion is lower and closer to the internal ring. In addition, when there is no testicle in the affected scrotum, intra-abdominal testicular torsion should be highly suspected.

During physical examination, the patient should first be examined in a standing position. If palpation is unsatisfactory, the patient should be examined in a supine position. Too cold a room should be avoided, and stimulation that causes the levator testis reflex should be avoided, because these factors may induce the levator testis reflex and testicular retraction. Sometimes a warm bath before physical examination is more conducive to examination. About 20% of cryptorchidism cannot be palpated during physical examination, which does not mean that these cryptorchidism are located in the abdominal cavity. During surgery, about 80% of the cryptorchidism that cannot be palpated can be found in the inguinal canal or near the internal ring. Among the remaining 20%, unilateral testicular agenesis accounts for about 3% to 5%, and bilateral testicular agenesis accounts for about 0.6%. During surgical exploration, about 65% of patients with testicular agenesis can find the spermatic cord and vas deferens stump at the internal inguinal ring. In this way, only 2% to 3% of all cases of cryptorchidism require intra-abdominal exploration to find the testicles.

These are some of the basics of this disease called epididymis. But mothers should not be too nervous. It is possible that your child is just developmentally delayed, so don't cause unnecessary panic. But if the disease is confirmed, the mother must pay more attention and make sure the child is healthy.