Cryptorchidism (Undescended Testes) is a condition present at birth in which one or both testes fail to descend through the inguinal canal into the scrotal sac. It is generally observed in preterm babies since the testes do not pass down from the abdomen to the scrotal sac until the seventh month of intrauterine life. Symptoms of undescended testes rarely cause discomfort. The entire scrotum, or one side, will appear smaller than normal and may appear incompletely developed.
If the testes do not descend spontaneously on the first 12 months of life, a child may receive human chorionic gonadotropin therapy or surgery (orchiopexy) that is performed between 1 to 2 years of age. Surgery prevents damage to the testes that may be affected by exposure to an increased temperature in the abdomen. In addition, early repair also prevents a negative effect on body image and embarrassment brought about by the difference in the appearance of the empty smaller scrotal sac. Undescended testes that are related to the presence of an inguinal hernia are repaired at the time of herniorrhaphy. Failure of the testes to descend can occur at any point along the normal path of descent into the scrotum.
The focus of nursing care planning in clients with cryptorchidism (undescended testes) is to provide preoperative and postoperative care, give emotional support regarding body image, decrease anxiety, and prevent the occurrence of complications.
Here are three (3) nursing care plans (NCP) and nursing diagnosis (NDx) for Cryptorchidism:
May be related to
- Change in the health status of the child
- Hospitalization and surgery of the child
- Threat to self-concept
Possibly evidenced by
- Presence of empty scrotum and smaller size
- Expressed concern about impending surgery or need for future surgery and procedure performed to correct the abnormality
- Increased apprehension and expressed concern about future infertility and effect on body image
- Parents verbalize decreased anxiety about child’s undescended testes.
|Assess origin and anxiety level
and how it is expressed; need for
information that will alleviate anxiety.
|Provides information about the level of anxiety and need for measures to relieve it; source for the parents include fear and
skepticism about treatment and recovery; source for the child include embarrassment by different shape and size of scrotum after school age.
|Provide as much privacy to the child as
possible during evaluations.
|Facilitates comfort and prevents embarrassment.|
|Allow expression of concerns and opportunity to ask information about the condition, diagnostic and surgical procedures, effect of abnormal placement on testes and future fertility.||Provides a chance to express feelings and fears and secure information to decrease anxiety.|
|Involve parents in decisions about care and routines as possible.||Allows for more control over a situation.|
|Communicate with parents (and child if appropriate) and answer questions calmly and honestly; May utilize aids such as pictures, models, and drawings.||Provide a calm and supportive trusting environment.|
|Inform parents that surgery is usually done after the age of 1 but may be performed during the preschool years by the age of 5 if no spontaneous descent of testes happened.||Provides knowledge about the need for surgical repair prior school age to avoid psychological and physical embarrassment to the child and that exposure to the higher temperature in the abdomen may impair testes and susceptible to infertility and tumor formation.|
|Provide parents with information about orchiopexy.||Explains the surgical procedure to correct the deformity.|
|Reassure the child that his penis will
remain in place and that the surgery will not harm the male organ.
|Allay any fear that the penis may be removed or cut off.|
|Instruct parents and child in activity restrictions and play appropriate to age and trauma of surgery.||Provides information about return to normal activity without damage to the incision area or disconnect the suture which may result in testes returning again into the inguinal canal.|
|Demonstrate and teach self-testicular examination and allow for return demonstration; inform to report any change felt.||Allows for early detection of a tumor.|
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