Pediatric Urology FAQs at UPMC

Cryptorchidism

If we wait for the baby to grow, can the testicle descend to the scrotum?

In rare circumstances, especially in babies who are born before term and in cases where the testicle has almost reached its physiological position, this could happen in the first months of postnatal life. After six months of life, spontaneous descent is very unlikely.

Is the intervention necessary or can it be treated with drugs?

Drug therapy (gonadotropins) was practically abandoned. Surgery is needed.

Is the intervention "invasive"?

No. It usually lasts about 30 minutes, and the child can resume normal activities on the same day of the surgery.

Will the baby be in pain after surgery?

Modest and not in every case.

Do the stitches need to be removed?

No, there are no sutures to remove.

Inguinal Hernia

Can a hernia heal on its own?

No. The 'disappearance' of the hernia is unlikely without treatment. Once it appears, it tends to be more and more noticeable.

Is it urgent or can the baby be expected to grow?

There is no reason to wait as it cannot spontaneously disappear. In infants, and even more so in premature babies, it is extremely dangerous as it frequently becomes complicated with incarceration (throttling) which can lead to serious damage to the testicle.

What are the consequences of not having surgery?

There is a risk of incarceration or hernial strangulation. The bowel that emerges from the abdominal cavity becomes congested and can no longer re-enter the abdominal cavity.

Are prosthetic meshes placed during the surgery?

In pediatric patients, no prostheses or reinforcing nets are used.

Is the intervention 100% decisive?

Relapse (recurrence) is very rare. It can, however, appear counter-laterally, especially if it was left untreated for some time before intervention.

Phimosis

Is “preputial gymnastics" useful?

Absolutely not, and in most cases, it can be harmful. In fact, the movements can create micro-lacerations of the skin which, by healing, make it less elastic.

Can applying cortisone ointment help?

Yes, in some cases.

What is the most suitable age to carry out the surgery?

If there are no recurring infectious episodes or other symptoms, surgery can be postponed until adolescence. The 'uncovering of the glans' in an individual who is not sexually mature is unnecessary.

Does it cause UTIs?

No, it does not generally cause urinary infections, but it can cause local infections.

Are there other types of interventions besides radical circumcision?

Yes, in some cases you can choose to perform a preputial plastic that leaves the glans completely covered, with a more "natural" result.

The Hydrocele and the Funicular Cyst

Can the fluid around the testicle be reabsorbed?

No, because it is continually supplied by a canal (the so-called vaginal peritone duct) with which we are born that makes the cavity that contains the testicle communicate with the abdominal cavity.

Is it necessarily have to be operated on?

After the third year of life, if persistent.

Is it a disease that causes infertility?

There is no relationship between hydrocele and infertility.

Does hydrocele cause pain?

No, it is asymptomatic.

Can hydrocele turn into hernia?

This occurrence is very rare. When something enters the vaginal peritoneum duct, it is almost always an omentum and not an intestinal loop.