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LE JOURNAL arrow LE JOURNAL arrow Santé arrow Quand ses testicules ne descendent pas




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07-02-2011
Bébé
Quand ses testicules ne descendent pas

Pendant la grossesse, les testicules de votre bébé se forment dans son abdomen, et elles se mettent en place dans ses bourses (scrotum) après sa naissance. L'ectopie testiculaire désigne tout testicule qui se trouve spontanément et en permanence en dehors des bourses et dont l'abaissement manuel est suivi d'un retour immédiat à la position initiale.
Cette anomalie n'est pas grave, mais elle nécessite toutefois une petite intervention chirurgicale.

Les testicules ascenseurs
Il est indispensable de faire examiner votre bébé à plusieurs reprises par votre médecin afin qu'il différencie l'ectomie vraie, qui demande une intervention, au problème très fréquent des testicules dits «ascenseurs» qui se trouvent, selon les jours, tantôt en position normale tantôt en position inguinale (région de l'aine ou à proximité).

Les testicules «ascenseurs», qui se fixeront de façon définitive dans les bourses à l'âge de la puberté au plus tard, ne demandent aucun traitement.

Comment se passe l'opération
D'une durée de moins d'une heure et conseillée vers l'âge de 2 ou 3 ans, l'intervention chirurgicale consiste, depuis une petite ouverture faite au niveau du pli de la cuisse (aine), à libérer le testicule et à le fixer dans les bourses. Sous anesthésie générale, l'opération est réalisée par un chirurgien spécialisé en pédiatrie qui saura éviter de tirer trop fort sur le pédicule spermatique. Si le testicule se trouve très haut dans le ventre, une seconde opération est parfois nécessaire.

Après l'opération, la douleur est généralement faible et la période d'hospitalisation est habituellement d'une journée. Votre enfant peut marcher et courir normalement. En revanche, il est conseillé de le garder une semaine à la maison s'il est scolarisé et de lui faire reprendre une activité physique importante au bout de trois semaines.

Quel risque ?
Le risque le plus fréquent est la stérilité, car les spermatozoïdes n'aiment pas la chaleur (supérieure ou égale à 37°), et ne se forment pas bien dans un testicule demeuré trop au chaud, c'est-à-dire dans l'abdomen.

Le fait d'avoir une bourse vide peut également entraîner un risque esthétique et psychologique ainsi que la cancérisation du testicule non descendu, un risque beaucoup plus rare mais plus grand que sur un testicule en place.
Nombre de mamans se demandent si leur petit garçon souffrira de séquelles à l'adolescence…

Rassurez-vous : après l'intervention, le testicule fonctionne normalement pour produire des spermatozoïdes et des hormones mâles. La fertilité est normale dans la grande majorité des cas, il est toutefois conseillé de faire surveiller votre enfant jusqu'à la puberté

 


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