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顏令朱醫生回覆 - Hi
So this 23 old brother has a single testicle in the scrotum with an "undefended testis" situated in the groin region.
We have two options:-
Orchidopexy - Surgery to move an undescended testicle into the scrotum
Orchidectomy - Surgery to remove the testicle
Both are considered a safe and effective procedure that have few risks, which include wound complications, bleeding, and pain
Orchiopexy is usually performed in babies and boys before their puberty but may also be done on older boys and, rarely, on teens and adult men who have undescended testicles. Untreated undescended testicles are usually removed in adult men and teens who have gone through puberty because of the increased risk of testicular cancer (20-40x risk).
Depending on the location of the testicle, one or two small incisions are made in the scrotum, the groin, or the abdomen to allow the surgeon to reach the testicle and move it to the scrotum or to remove it if it was decided. For a teen or adult who has an undescended testicle, surgery is generally recommended after puberty and up to about age 32. It makes it easier to check the testicle for cancer. The risk of testicular cancer gets less and less after age 34. So if you are an adult and you are thinking about treatment for your undescended testicle, talk with your doctor about the pros and cons of surgery.
Best Regards,
Dr Renny LC Yien
Specialist in General Surgery
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李澤民醫生回覆
- 如有泌尿科回覆最好。因年紀不少，可能要切走，方法請問主診。
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李建業醫生回覆
- Apple 提出查詢回覆如下：
Apple 弟弟的情況多為睪丸未降或隱睪，是指睪丸未能下降至陰囊。睾丸未降有機會導致降低生育能力 及增加睾丸腫瘤風險， 也更容易出現睾丸扭轉及壞死和腹股溝疝。
醫生會對病人的腹部及生殖器部位進行臨床檢查，更會利用超聲波或電腦斷層掃描等影像測試，來確定睪丸的位置和狀況。此外，醫生亦可能會安排進行精液分析，以作出生育能力評估。如有適應証，便須要對病人進行腹腔鏡手術探查。
治療方法視乎患者的年齡、睪丸未降的性質及位置而定，其中包括腹股溝睪丸固定術或睪丸切除術。
腹股溝睪丸固定術是在腹股溝部位開一個小切口，仔細將睪丸、輸精管和睪丸血管與附近的組織分離。並在陰囊另開一個小切口, 形成肉膜窩，將睪丸送進並固定在內。風險及併發症包括出血、 感染、及不常見的情况如：
• 睪丸血管受到損傷，導致睪丸萎縮
• 睪丸、附睪或輸精管受到損傷
• 睪丸不能進入陰囊
• 隱睪復發，須要進行另一次手術
• 陰囊或腹股溝水腫。
而睪丸切除術是在腹股溝部位或陰囊開一個小切口，將精索內的血管和輸精管結紥，然後將睪丸取出。常見的風險及併發症包括出血、感染、及不常見有可能發生的副作用：
• 失去性興趣
• 勃起問題
• 失去生產精子及生育的能力（不育）。
謝謝
李建業醫生上
醫務信箱
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