Dear Doc | My infant son has no testes

Q. Dear Doc, I am concerned that my son has no balls. I noticed it when he was born, but now he is nearly a year old and they still not there. His father keeps asking what’s wrong with him and if he doesn’t have any, if his penis will work when he gets older.

A What you are describing is called undescended testes. It is always a cause for concern for parents because of the obvious abnormal appearance to the genital region, as well as similar questions about the child’s future sexual functioning.

Testes is another word for testicles (balls); and they are found inside a skin sac called the scrotum. Now to help explain this condition, let me explain how baby boys testes develops. Before a boy is born, his testes are inside the lower part of his belly. Just before birth, the testes move down into the scrotum. When this does not happen, it results in undescended testes. It can happen to one or both testes.

Now sometimes, one or both testes do not develop normally because of a problem that happens before the baby is born, and this is called absent testes.

Now how can you tell if your baby has undescended testes?

Most of the time, the doctor finds the undescended testes while doing an exam on the baby soon after birth, and it is more common in babies who are born earlier than normal.

In most cases, no treatment is needed because the testes move down to the scrotum within a few months after birth. If that does not happen, as in your son’s case, treatment usually involves surgery to move the testicles into the scrotum. Surgery can be done as soon as possible after the child is four months old. It should be done before he is 2 years old.

Men who had undescended testes in childhood are more likely to have cancer of the testes. Cancer of the testes is rare however, even if a man had undescended testes, but the doctor will do exams to check for this at yearly visits.

Men who have undescended testes in childhood are also more likely to have trouble getting a woman pregnant (infertility). This problem is more common in men who had two undescended testes, however, most of these men are still able to get a woman pregnant.

 

 

 

Q Dear Doc

I have a peculiar problem. I am a man and I have breasts, like woman-looking breasts. It’s not fat, because I go to the gym and exercise and they are still there. I am very self conscious about it, especially when people comment and ask questions, especially recently when somebody asked if I have to do mammograms on them too like women. Now I am wondering if I can just have them removed?

A What you have is what is called gynecomastia.

Gynecomastia, is the medical term for when boys or men develop breasts. As you rightly expressed, this can be embarrassing and even painful. Luckily, it often goes away on its own. If it doesn’t go away however, or if the condition is very uncomfortable, there are treatments that can help.

There are a number of treatments for gynecomastia, but treatment will depend on the cause of your condition, how long it has lasted, and how severe it is.

In adult men, breast development can be caused by a health problem or by a medication you may be taking. In such cases, treating the health problem or stopping the medication, usually makes the breasts go away. But if the doctor can’t figure out the cause of breast development, he or she might prescribe a medication called tamoxifen.

However, if the breasts are large and have been there for more than a year, medicine does not usually help, and instead, surgery is usually recommended to reduce the size of the breasts.

You should also see a doctor if your breasts are:

- Growing very fast

- More than 2 to 3 inches of tissue under the nipple

- Very painful

You should also see a doctor if you have a lump in your breast that is off to the side instead of under the nipple. This could be a sign of breast cancer. It is very rare, but men can sometimes get breast cancer.

In such an instance, your doctor will examine them to check if what you have is really breast tissue or if it is fat, which is not the same thing. If a suspicious lump is detected, then yes, a mammogram will be recommended.