John Jashon O., 4

John is a 4-year-old boy who lives with his mother and is the firstborn in a family of two children. He enjoys spending time playing with his younger sister and particularly likes eating rice and beans. He was brought to the hospital with a history of an empty scrotum noted since birth. His mother also reports intermittent swellings in both groin regions, which are sometimes associated with pain. There is no history of abdominal pain or vomiting. John has been diagnosed with bilateral cryptorchidism, a condition in which both testes have failed to descend into the scrotum. Normally, the testes form in the abdomen during fetal development and move down into the scrotum before birth. In this case, both testes have remained either in the abdomen or within the inguinal canal. Undescended testes are exposed to higher temperatures than normal, which can affect their function and structure. This condition increases the risk of complications such as testicular torsion (twisting of the testis), inguinal hernia, trauma, and long-term damage to the testicular tissue. If not corrected early, it may also increase the risk of infertility and testicular cancer later in life.

Patient presented to the facility on 03.03.2026 with empty scrotum since birth. Patient had on and off irritability. Presented with empty scrotum testicles in the inguinal region, ws transfused then booked for bilateral orchidopexy which was succesfully done. Patient discharged home in a stable condition with oral drugs as per the attached discharge summary and prescription.

John presents with bilateral undescended testes associated with intermittent bilateral inguinal swellings and pain, which raises concern for associated inguinal hernia. The persistence of cryptorchidism beyond infancy (now at 4 years of age) indicates delayed diagnosis and management, increasing the risk of complications. With timely surgical intervention (orchidopexy), the prognosis is generally good. The procedure significantly reduces the risk of complications such as testicular torsion, hernia incarceration, and trauma. However, if the correction is delayed further, since it is also beyond the recommended age (ideally before 1–2 years), there may be some impact on future testicular torsion risk and a slightly increased lifetime risk of testicular malignancy compared to children treated earlier.