Nicky's Testes

So we had our first visit at CHEO this morning. The kids were good this morning to get up, dressed and fed quickly enough that we were on our way with enough time to stop to pick up a Starbucks, so that's a good start to the day! Nicholas slept the whole way, so I got some quiet time both on the way there and the way back, so that was good too - especially after the less than stellar night last night.

We got to CHEO with time to spare - thank goodness because there was no parking! They were only allowing cars into the parking lot as others left! What's up with that?! Anyway, I end up parking at the General and walk over - just a short walk, but still very expensive parking! We finally find our way around and wait for about 45 minutes for our appointment. Dana's right though, the urology department is very nice. They took their time to explain things to me very well and answer all the questions I could come up with at the time. They made me feel very comfortable despite what the next steps will be. So - what's the deal? Read on...

Some of the stats (paraphrased, this is not a paper on the topic): 2-4% of boys have one or both undescended testicles. It tends to run in families, but isn't always the case. Why is this an issue? It can affect fertility (the testes are out of the body to be at a lower temperature to make the little swimmers) and the more serious issue is that it increases the risk of testicular cancer. There was a study done recently in the UK to see if performing the surgery to lower the testes into the scrotum helped to better the odds of not getting cancer and it seems to point that way, but the test group was too small to be conclusive. The real reasons to bring them down is to help with the fertility issues and to make it possible to detect lumps, etc. and get an early diagnosis if there is cancer.

What does this all mean for my poor little baby? Well, the one that was down and now is not isn't very far up. It's easy to feel and the Dr was easily able to push it into the scrotum, so he doesn't feel that he needs to do anything with that one. We'll just watch and hope that it comes down again on its own. The other one is harder to find, but was also felt. Lucky for us, it's fairly low (below where the pubic hair line would be, I think) so it may be an easier procedure to bring it down into the scrotum. As long as they can still feel it there on the day of surgery, they would simply make a small cut (5-7 mm or something like that) and put something in to lower it into the sack. They'd also have to make a small insicion in the scrotum to secure the teste in place (they'll sew it in there to keep it down). As long as they can find it easily and that it isn't kept high because of something too tight, then that's it, all done in about 1 hr. If they can't find it easily, then they may need to do a laparoscopy where an incision would be made just below the bellybutton to get a scope in to go find it. Once found, the surgery is the same as above, but the whole thing could take closer to 2.5 hrs. I guess the worse case scenario would be that they do that and things are too tight in there and they can't get it all the way down. They'd then do something (I don't really know at this point) to get it half way there and then do the same thing again about 6 months later. I really hope we don't end up there, we'll see.

So what happens next? He's on the list for surgery (and on the cancellation list so that we can hopefully get this all out of the way before we move). They recommend that everything be done before boys are 18 months so they remember nothing about the experience (the Dr had some fancier words there). Basically, anytime after 6 months is good for them and the sooner the better. I'll get a call when they have an appointment and I'll have to meet with an anesthesiologist ahead of time too. On the day of surgery, he can't eat after midnight but can be nursed until 4 hrs before and get clear liquids until 3 hrs before. We show up 2 hours early and they start prepping. I (or Trevor) can be in the room until he's asleep and they'll come and get us as soon as he wakes up. I hate even just thinking about that. What's great - he doesn't even have to spend a night! He'll then be prescribed codeine for a couple of days and on Tylenol for a while for the soreness and is supposed to be kept from doing anything too strenuous for a week and no "sports" and straddle toys, etc. for 4 weeks. Have they met Nicholas?! How the heck am I going to keep him from being too active for a week?! Aaah! We'll see... I think that worries me as much as the actual procedure!

That's basically the gist of it. I have a bunch of papers they gave me to read and a few websites to have a look at - if I find anything interesting, I'll add links later. I may have forgotten something, but that's basically it. I'm really tired! What a day!