Cryptocyroidism

diagnosis:

The most common diagnostic dilemma in otherwise normal boys is distinguishing a retractile testis from a testis that will not/cannot descend spontaneously into the scrotum. Retractile testes are more common than truly undescended testes and do not need to be operated on. In normal males, as the cremaster muscle relaxes or contracts, the testis moves lower or higher ("retracts") in the scrotum. This cremasteric reflex is much more active in infant boys than older men. A retractile testis high in the scrotum can be difficult to distinguish from a position in the lower inguinal canal. Though there are various maneuvers used to do so, such as using a crosslegged position, soaping the examiner's fingers, or examining in a warm bath, the benefit of surgery in these cases can be a matter of clinical judgement.

A nonpalpable testis is typically observed by the parent or detected during routine physical examination by a nurse or physician. If one testis is not palpable, the affected hemiscrotum will appear smaller than the other, while both hemiscrota appear small with bilateral nonplapable testes. In the case of retractile testes, the parents may report intermittently observing the testis in the scrotum, frequently when the child is being bathed in warm water.

outcome:

Expected Outcomes Child and family verbalize understanding of surgery Clear urine draining via catheter Child and family verbalize relief that defects can be surgically repaired and reconstructed Incision without drainage or signs of infection Vital signs stable; urine output adequate Decreased crying and increased restful periods and sleep noted

plans of care:

Nursing Assessment

Obtain history from prenatal and birth record, family, and child

Assess feeding and crying patterns, indicating potential obstruction or abdominal pain

Assess urinary elimination pattern to determine degree of disorder. Assess for associated congenital defects

Assess for failure to thrive....