Undescended Testes

What is an undescended testicle?

The undescended testicle is the most common birth abnormality involving the male genitals. A testicle that does not occupy a dependent scrotal position at birth is undescended.  The condition occurs in about 10% of premature infants and 3% of full-term babies. In some cases, both testes are undescended, but most often the problem affects only one testicle. In most cases, the testis will descend on its own within the first few months of life. Sometimes an overactive muscle in the scrotum may make it appear as though a young boy has an undescended testicle , but this condition, called retractile testicle, is different and does not require treatment.

What causes undescended testicles?

The testes develop within the fetus’s abdomen during gestation and migrate down to the scrotum before birth. In undescended testicles, the normal migration stops in the abdomen or groin area.  Genetic factors and maternal hormones may play a role in this process.

What are the symptoms of undescended testicles?

If uncorrected, an undescended testicle can be associated with infertility, inguinal hernia, an increased risk for testicular tumor, psychological difficulties surrounding the appearance of the genitals,  or injury due to twisting (torsion) of the testicle.

How is an undescended testicle diagnosed?

The diagnosis of undescended testicle is based on physical examination

How are undescended testicles treated?

The most effective treatment is surgical correction (orchiopexy). The ideal timing for surgery is around 1 year of age,. If the testicle has not descended by one year of age, it is unlikely to descend as the child gets older.

If the undescended testicle is located in the groin area, a surgeon makes a small incision in that area, frees the testes from any constraining tissue and then sutures it into place in the scrotum, using a small scrotal incision.

If the testicle is in the abdomen, it is repositioned in the scrotum using a laparoscopic procedure.

What happens after treatment?

Surgical correction is performed in the outpatient surgery center and your child will be able to go home on the same day of surgery. Your child will typically want to take it easy for the first few days after surgery.  Once your child feels up to it they may gradually resume regular activity.  This usually occurs within about a week. Your child should wait to resume strenuous activity such as swimming, gymnastics, or ball playing for 2 weeks after surgery.