I Am A 65 Year Old Old Male With An

Posted on Wed, 4 Mar 2020

Question: I am a 65 year old old male with an uncorrected undescended testicle. I see a urologist for a low testosterone problem because my good testicle has become atrophied. She does not seem concerned about the increased cancer risk with the abdominal teste. She ordered an ultrasound but it did not detect the ectopic teste. I must have surgery to repair an umbilical hernia, should I have surgeon look for ectoptic teste

Answered by Dr. Manuel C See IV (40 minutes later)

Brief Answer:
No, you don't need surgery for this.

Detailed Answer:
Good day thank you for being with 'Ask A Doctor' service!

The site of the umbilical hernia repair is different and far from where the ectopic testis this could be.

Also, I believe there is a very big chance that the ectopic testis is already atrophic and is very small and may not even be located during surgery.

The reason I think why your urologist is not concerned about cancer is because the ectopic testis was not found during the ultrasound and if there is a mass in that testis then the ultrasound will pick up that immediately.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Manuel C See IV (3 hours later)

My concern involves increased risk of testicular cancer in the ectopic testis. Since the testicle cannot be physically examined would it be reccomded to have periodic ultrasound done to check for cancer as compared to waiting for symptoms to occur and possibly affecting outcome of treatment. My parents and grandparents lived to 96 to 99 and I would like to also reach that point. I exercise regularly and maintain an active life. I was a registered pharmacist for 40 years and recently retired and have begun another business venture. I am overly cautious and should I just forget about it

Answered by Dr. Manuel C See IV (4 minutes later)

Brief Answer:
You may do a diagnostic laparoscopy or an mri

Detailed Answer:
i understand your concern but testicular cancer is rare even for ectopic testis. the best imaging to do is an mri with contrast to determine the location and presence of the ectopic testis. another way is request for a diagnostic laparoscopy to be able to visualize the testes prior to doing the umbilical hernia repair.

you may request your urologist regarding my suggestions but since testicular cancer in an ectopic asymptomatic patient is rare your insurance may not cover the procedure or the imaging modality for that matter.

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Above answer was peer-reviewed by : Dr. Vaishalee Punj