Undescended Testes

Definition

A child's testicles develop before birth. They start inside the abdomen. The testicles should then move down into the scrotum just before birth. Undescended testes stay in or return to the abdomen. A true undescended testicles situation is present at birth. The testicle remains in the abdomen until treated. Other situations that allow the testicles to go up into the abdomen include:

  • Retractile testicles—the testicles can move freely between the scrotum and abdomen. This condition does not require treatment and usually disappears by puberty.
  • Ascending testicles—a normal testicle returns to the abdomen
Undescended Testis
si55551452 96472 1
Copyright © Nucleus Medical Media, Inc.

Causes

Undescended testicles are often caused by a disruption in the development of the testicles. The cause of this disruption is not clear. Genetics may play a role. There may also be some problems with the hormones that help testes develop. The testicles may also have been injured at some point during the pregnancy.

Risk Factors

Factors that may increase your child's risk of undescended testicles include:

  • Prematurity
  • Low birth weight
  • Twin gestation
  • Down syndrome or other chromosomal abnormality in the fetus
  • Gestational diabetes mellitus
  • Prenatal alcohol exposure
  • Prenatal exposure to cigarette smoke
  • Hormonal abnormalities in the fetus
  • Toxic exposures in the mother
  • Having a mother younger than 20
  • A family history of undescended testes

Symptoms

The main symptom is not being able to see or feel the testicle.

Diagnosis

The doctor will ask about your child's symptoms and medical history. A physical exam will be done. A diagnosis is usually made during the physical exam. The doctor will note that one or both of the child’s testes cannot be felt within his scrotum.

The doctor may need to view your child's bodily structures. This can be done with laparoscopy .

Treatment

Undescended testicles are treated because they may increase the risk of certain health conditions such as:

  • Infertility or low fertility—a testicle is more likely to produce sperm in cooler temperature as in the scrotum, the heat inside the body is too high for sperm production.
  • Testicular cancer
  • Torsion—testicles twist enough so that they cut off the blood flow to the testes. This can cause severe damage to the testicles.
  • Emotional distress—as the child ages, they may have problems with the appearance of the empty scrotum.

Talk with your doctor about the best treatment plan for your child. Treatment options include:

  • Giving the problem time to go away on its own:
    • In most children, the testes will descend on their own by four months of age.
    • Retractile testicles will completely descend at puberty. Further treatment is not needed.
  • Hormone therapy with human chorionic gonadotropin (HCG) :
    • This treatment is not used often.
    • The hormone helps stimulate testicle development. This may encourage the testicle to move down.
  • Surgery called orchiopexy:
    • This is done while your child is asleep under anesthesia.
    • It is often done with laparoscopic surgery. The doctor make tiny incisions in the area.
    • The testicle is moved down and stitched into place.

Prevention

There is no known way to prevent undescended testes.

Revision Information

  • American Academy of Pediatrics

    http://www.healthychildren.org

  • National Infertility Association

    http://www.resolve.org

  • Health Canada

    http://www.hc-sc.gc.ca

  • Infertility Awareness Association of Canada

    http://www.iaac.ca

  • Cryptorchidism. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated June 27, 2013. Accessed July 16, 2013.

  • Docimo S, et al. The Undescended Testicle: Diagnosis and Management. Am Fam Physician . 2000 Nov 1;62(9):2037

  • Undescended testicles. American Academy of Family Physicians Family doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/undescended-testicles.html . Updated December 2010. Accessed July 16, 2013.

  • Undescended testicles. American Academy of Pediatrics' Healthy Children website. Available at: http://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Undescended-Testicles.aspx . Updated March 11, 2013. Accessed July 16, 2013.

Quick Links

Connect with Us!

7401 South Main Street
Houston,
Texas
77030
(713)799-8600