What are undescended testicles

Undescended testicles also known as cryptorchidism, is when a testicle fails to drop into the normal place in the scrotum.  As a baby boy develops inside his mother’s womb, the testicles begin forming in the lower abdomen.  About eight weeks before birth, the testicles will move down into the scrotum or the sac that hangs below the penis.  The testicles attach themselves with stretchable tissue in the bottom of the scrotum which is controlled by the baby’s normal hormones.  In some cases however, one testicle may remain in the lower abdomen without descending into the scrotum. In rare cases, both testicles are undescended.

Undescended testicles are found in about three or four out of 100 newborns – up to 21 out of 100 premature baby boys. 

Causes of undescended testicle

It is not entirely known why a testicle does not move down into the scrotum but it may be an inherited condition in some families.  It could be that the baby’s hormones did not stimulate the testicles normally or that the testicle did not attach in the scrotum.  In other situations, it is often the result of a baby boy born prematurely or who weighed less than 5 pounds at birth. 

Generally, in about half of baby boys born with an undescended testicle, the testicle will descend or drop on its own by the time the baby is 3 months of age.  After three months of age, an undescended testicle will not drop on its own and then will need treatment for this. 

Symptoms

There are few symptoms associated with an undescended testicle as it does not cause pain or other issues.  The main symptoms have to do with the appearance of the scrotum – it may look smoother, flatter or less developed on one side compared to the other testicle. 

Diagnosing an undescended testicle

At birth and well-baby visits, a pediatrician will check a baby boy’s scrotum, feeling for the testicle.  If they discover the testicle can be felt but is not in the scrotum, the baby will need to be rechecked again at age three to six months.  Usually the undescended testicle will have moved into place on its own by this time. 

If the undescended testicle is still in the baby’s belly, too small to feel, or absent, then the doctor will not be able to feel it at all. 

Treating an undescended testicle

If the testicle does not move down into the scrotum on its own or can’t be felt or is palpable, then the doctor may recommend a type of laparoscopy surgery called orchiopexy to find the testicle. This safe and effective surgery is performed when the baby is 9 to 15 months old and uses thin tubes requiring a small incision below the belly button.  The surgery is often performed by a pediatric urologist who will use a special camera to see inside the baby’s abdomen.  Once the testicle is found, it is freed from nearby tissue to make it easier to move into the scrotum.  If a hernia is also found, that will be fixed at the same time.  Overall the success rate with surgery is 98 out of 100.

What happens if the undescended testicle is left untreated?

If the undescended testicle is left untreated, there are several risks associated with this:

·An undescended testicle can increase the risk of developing testicular cancer and infertility later in life

·The undescended testicle could twist, cutting off its own blood supply causing pain in the groin or scrotum

·A boy growing up with an empty scrotum can make him feel bad about himself and his body, especially during the teen years

·If the testicles are left in the lower abdomen or groin area, a boy will have a higher risk for sport injuries and discomfort when wearinga seat belt