My son could have developed testicular cancer if we hadn’t checked his scrotum

Carolyn* had two boys already, so when her third came along and everything appeared to be fine in his downstairs department she didn’t give it another thought. That is, until almost a year later when her husband discovered their son was missing a testicle.

Here’s her story…

Testicle territory

I come from a family of all girls with no brothers, or even male cousins living near by, so I didn’t know much about little boys before I had them. And when my third was born everything looked like it was in the right place so I just went about caring for him as I’d done the others.

When he was about nine or ten months old, my husband was changing his nappy and told me I’d better take him to the doctor because he couldn’t feel anything in his right scrotum. I didn’t know what he was talking about. There were two sacks there so what was the problem? He got me to feel it and I could definitely tell something was wrong – on one side of the scrotum I could feel a little ball and on the other it was empty with just loose skin.

Where had it gone?

Not knowing anything I naturally freaked out. What had happened to it? I spoke to my husband (who happens to be a doctor) and did some research, and discovered that it’s quite common for a testicle to take a while to descend after birth. A condition called cryptorchidism, it can also happen the other way where the testicle goes back up in infancy. In both cases the testicle usually does eventually descend, and if it doesn’t a simple surgical procedure can relocate it in the right position.

However, this wasn’t what had happened with my son.

A twist in the story

After a doctor check up confirmed there was no testicle, my son was then referred to a paediatric surgeon who ordered an ultrasound to scan the abdomen (where the testes are formed) – something not normally required for general cryptorchidism. Sure enough the scan found a very, very small testicle there but I was informed that it was actually dead. They think that on its way down the testicle had twisted, cutting off its blood supply which then left it withered and in the same place.

A condition called testicular torsion, it’s most common in boys aged 12 to 18, but apparently can also occur in babies and even adults. When the actual twisting happens it’s extremely painful and involves other symptoms like swelling and vomiting, but this wasn’t the case with my son because it most likely happened in the womb before he was born. The only sign we therefore had was physically feeling its absence.

Need for surgery

If treated quickly, testicular torsion can be corrected where they untwist the testicle. For my son though this wasn’t an option as the testicle had already died. The surgeon advised us that his other testicle was a good size and viable which was a huge relief, but said he needed to remove the dead testicle as if left there was a high probability of it turning cancerous which was a terrifying thought.

Apparently they used to wait until children were around five or older to perform an orchiectomy (testicle removal), however the recommendation now is at age one. My son therefore had to be booked in almost straight away, which although was scary because he was so young and had to go under general anaesthetic, I agreed to it.

Thankfully the surgery was a success with the dead testicle removed and the risk of my son getting testicular cancer down the track reduced. At the same time they also did another procedure where they stitched his other good testicle in place to prevent it from twisting as well – something which if it occurred and resulted in this testicle also dying would mean my son would be infertile. Again, another scary thought.

A full recovery

Children are amazing and my son bounced back so quickly after the surgery which was a huge relief. Other than not being allowed to bathe him for a few weeks to prevent the stitch from coming undone, the recovery was fast and simple. Even nappy changes were fine.

My son is six now and to look at him you wouldn’t notice a thing – visibly he looks the same as his brothers, but just inside his scrotum there is one empty sack. I’ve been told he won’t have any issues with fertility by only having one testicle, and his hormones won’t be affected during puberty which is very reassuring. No more check ups or treatment are needed too.

So although the whole ordeal was quite nerve wracking, the condition is quite easily fixed – but only if you know about it.

It could have been missed

If I hadn’t had a husband who was a doctor or actively hands-on with things like changing nappies, then my son would possibly still be walking around with a twisted dead testicle. I had no knowledge that this sort of thing could happen and had never even thought to check within the scrotum sack.

You have so many check-ups for babies and children that you assume anything out of the ordinary will be picked up, but it’s not always the case. Apparently at my son’s first paediatrician check up he mentioned that one testicle wasn’t there – I don’t actually recall it at the time but my husband does, possibly because I was still in a sleep deprived newborn funk with two other children to look after too. Why it wasn’t flagged as something to check later on though I’m not sure, but luckily my husband thought himself to follow it up.

Check your sons

Of course it’s possible that at later GP checks it would have been picked up, but there is no guarantee of this and therefore I think it’s really important for parents of boys to check their scrotum at least once or twice. A good way to do it is when they’re in a warm bath and already naked. Testicles tend to float and you’ll be able to see the outline of the actual testicle inside without even physically feeling them. Just be careful not to squash them and if you’re unsure ask your doctor to check as well.

I guess what happened to my son was just one of those things, but I’m glad we were able to discover it and treat it quickly to avoid any problems for him later in life.

Have you discovered any strange medical issues with your babies that doctors missed?

*Name has been changed for personal privacy reasons.

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