Undescended Testicle

An undescended testicle (cryptorchidism) is the absence of one or both testicles from the scrotum. In the womb, the testicles form inside the abdomen and then move down (descend) through a space between the groin muscles into the scrotum. Sometimes the testicles do not descend or only descend into the inguinal canal but not the scrotum. In most cases, undescended testicles will descend within the first 4 months after birth.

It is important to get treatment for an undescended testicle. Getting treatment will lower the chance of infertility and testicular cancer. Sperm production can begin as early as 12 months of age, so it is recommended that treatment occur between 6 and 12 months of age.

What are the causes?

• Hormone abnormalities.
• A blockage that prevents the testicles from dropping into the scrotum.
• Abnormalities in structures or muscles in the testicles.

What increases the risk?

• Low birth weight.
• Cerebral palsy.
• Certain genetic syndromes, such as Down syndrome, Noonan syndrome, or prune-belly syndrome.
• Being born bottom-first. This is called the breech position.
• A family history of undescended testicles.
• Neural tube disorders, such as myelomeningocele.
• Having a mother who is older, had gestational diabetes, or was exposed to any of the following during pregnancy:
  • Estrogen hormones.
  • Cola drinks.
  • Pesticides.
  • Medicines for pain.

What are the signs or symptoms?

The main symptom of this condition is not feeling or seeing a testicle where you would expect it to be.

How is this diagnosed?

Undescended testicles are diagnosed with a physical exam. During this exam, a health care provider will check to see whether the testicle is still in the abdomen.

If the testicle is not felt during the physical exam, a procedure called laparoscopy may be done to find out where the testicle is located or whether there is a testicle at all. During this procedure, a small incision is made and a thin, lighted tubeis used to look into the abdomen.

How is this treated?

• In children, this condition is treated with surgery to move the testicle down into the scrotum.
• In adults, the undescended testicle may be removed, as it is not likely to make sperm.

Follow these instructions at home:

• Monitor the scrotum for any changes.
• Keep all follow-up visits. This is important.

Get help right away if:

• The scrotum swells, becomes discolored, or appears bruised.
• There is severe pain in the scrotal area.

Summary

• It is important to get an undescended testicle treated to lower the chance of infertility and testicular cancer.
• Babies born prematurely are most at risk for this condition.
• If the testicle is not felt during a physical exam, a procedure may be done to find out where the testicle is located or whether there is a testicle at all.
• In children, this condition is treated with surgery to move the testicle down into the scrotum. In adults, the undescended testicle may be removed, as it is not likely to make sperm.