Undescended Testicle

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Undescended Testicle

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What is an undescended testicle?

As a baby boy grows inside his mother, he develops testicles. Early in his development, his testicles are in his belly. Normally, before he is born, his testicles move down into his scrotum, the sac that hangs below the penis. When one testicle does not move into the scrotum as it should, the baby has an undescended testicle. In rare cases, both testicles are undescended.

About 5 out of 100 baby boys are born with an undescended testicle.1 It is most common in babies who were born before their due date or who were very small at birth.

Doctors don't really know what causes an undescended testicle. This common condition runs in some families (can be inherited).

Most of the time, the testicle descends (drops) on its own by the time the baby is 3 months old. If your baby’s testicle hasn't dropped by the time he is 6 months of age, your doctor may suggest treatment.

What are the symptoms?

An undescended testicle doesn't cause pain or other symptoms. The scrotum may look a little smoother or less developed on one side, or the side without a testicle may look smaller and flatter. You can't feel the testicle in the scrotum on the side where it hasn't descended.

How is an undescended testicle diagnosed?

At newborn and well-baby visits, your doctor will check your baby’s scrotum.

  • If the testicle can be felt but it is not in the scrotum, the doctor will probably want to check your baby again at 3 to 6 months of age. By this time, the testicle may have moved into place on its own.
  • Sometimes the doctor can't feel the testicle at all. It could still be in the baby's belly, it could be too small to feel, or it could be absent. The doctor may recommend a type of surgery called laparoscopy to see if he or she can find the testicle. Laparoscopy requires only a small cut below the belly button, which heals quickly.
  • If both testicles are undescended and can't be felt in the groin, the doctor will do a blood hormone test to find out if the testicles are absent. This means having no testicles at all. It is very rare to have two absent testicles.

Some other conditions are closely related to undescended testicles, such as an ectopic or retractile testicle. In both of these conditions, the testicle is in an abnormal position in the groin or scrotum. Your doctor will take care to make the correct diagnosis so your child can get the right treatment.

How is it treated?

Usually doctors recommend a wait-and-see approach for newborns. If the testicle hasn't dropped on its own within 6 months, your doctor may recommend surgery (orchiopexy or orchidopexy). Surgery is done when the baby is 9 to 15 months old. It is safe and effective and has few risks. Most babies recover quickly.

When babies have a testicle that can't be felt, doctors may do a different surgery that needs only a small cut (laparoscopy).

Another treatment is hormone therapy. It may cause the testicle to drop down into the scrotum. If it works, surgery isn't needed. But it doesn't always work, and it may cause side effects.

Why is it important to treat an undescended testicle?

Treatment is important, because having an undescended testicle increases the risk of:

  • Infertility. Damage to a testicle's sperm-making ability can begin as early as 12 months of age. That's why many doctors advise treating an undescended testicle by the time a baby is 1 year old and no later than age 2.
  • Cancer of the testicles. Men who have undescended testicles have a higher rate of testicular cancer than other men. But this cancer is rare. It can be cured if found early. If you are a young man who has an undescended testicle, talk to your doctor about what you should do.

Other Places To Get Help

Organizations

American Academy of Family Physicians
P.O. Box 11210
Shawnee Mission, KS  66207-1210
Web Address: www.familydoctor.org
 

The American Academy of Family Physicians offers information on adult and child health conditions and healthy living. Its Web site has topics on medicines, doctor visits, physical and mental health issues, parenting, and more.


Canadian Paediatric Society
2305 Saint Laurent Boulevard
Ottawa, ON  K1G 4J8
Phone: (613) 526-9397
Fax: (613) 526-3332
Email: info@cps.ca
Web Address: www.cps.ca
 

The Canadian Paediatric Society (CPS) promotes quality health care for Canadian children and establishes guidelines for paediatric care. The organization offers educational materials on a variety of topics, including information on immunizations, pregnancy, safety issues, and teen health.


Canadian Urological Association: UroInfo
Web Address: www.uroinfo.ca
 

The information on this website has been written by physician members of the Canadian Urologic Association. The aim of the website is to provide important, honest, and balanced information regarding urologic health.


KidsHealth for Parents, Children, and Teens
4600 Touchton Road East, Building 200
Suite 500
Jacksonville, FL  32246
Phone: (904) 232-4100
Fax: (904) 232-4125
Web Address: www.kidshealth.org
 

This Web site is sponsored by Nemours Foundation. It has a wide range of information about children's health, from allergies and diseases to normal growth and development (birth to adolescence). This Web site offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly e-mails about your area of interest.


UrologyHealth.org, American Urological Association
1000 Corporate Boulevard
Linthicum, MD  21090
Phone: 1-866-RING AUA (1-866-746-4282) toll-free
Phone: (410) 689-3700
Fax: (410) 689-3800
Email: auafoundation@auafoundation.org
Email: patienteducation@auafoundation.org
Web Address: www.urologyhealth.org
 

UrologyHealth.org is a website written by urologists for patients. Visitors can find specific topics by using the "search" option.

The website provides information about adult and pediatric urologic topics, including kidney, bladder, and prostate conditions. You can find a urologist, sign up for a free quarterly newsletter, or click on the Urology Resource Center to find materials about urologic problems.


References

Citations

  1. Elder JS (2007). Disorders and anomalies of the scrotal contents. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 2260–2265. Philadelphia: Saunders Elsevier.

Other Works Consulted

  • Elder JS (2007). Disorders and anomalies of the scrotal contents. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 2260–2265. Philadelphia: Saunders Elsevier.
  • Pettersson A, et al. (2007). Age at surgery for undescended testis and risk of testicular cancer. New England Journal of Medicine, 356(18): 1835–1841.
  • Schneck FX, Bellinger MF (2007). Abnormalities of the testes and scrotum and their surgical management. In AJ Wein, ed., Campbell-Walsh Urology, 9th ed., vol. 4, pp. 3761–3798. Philadelphia: Saunders Elsevier.
  • Siegel NJ (2003). Cryptorchidism section of Kidney and urinary tract. In CD Rudolph et al., eds., Rudolph's Pediatrics, 21st ed., pp. 1740–1742. New York: McGraw-Hill.
  • Walsh TJ, et al. (2007). Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. Journal of Urology, 178(4, Part 1): 1440–1446.
  • Zeitler PS, et al. (2011). Cryptorchidism section of Endocrine disorders. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., pp. 973–974. New York: McGraw-Hill.

Credits

By Healthwise Staff
Primary Medical Reviewer John Pope, MD - Pediatrics
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Peter Anderson, MD, FRCS(C) - Pediatric Urology
Last Revised June 14, 2011

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