The testicles are male sex organs responsible for producing sperm and hormones. The testicles form in the abdomen and typically descend into the scrotum during fetal development. If one or both testicles remain in the abdomen, it is an undescended testicle.
This common condition typically resolves itself shortly within the first few months of life. However, surgery may be necessary in some instances.
The medical term for an undescended testicle is cryptorchidism.
You should be able to see or feel two distinct testicles when viewing a male baby’s scrotum (the sac-like organ beneath the penis). The scrotum may appear bag-like or empty in babies with an undescended testicle. The scrotum may also appear smaller than normal or uneven.
The exact cause of an undescended testicle is not known. However, researchers believe that a combination of certain factors is likely to play a role. These include:
- the mother’s health
- environmental factors such as exposure to pesticides or secondhand smoke
Physicians consider premature birth a major contributing risk factor for an undescended testicle.
Nearly one-third of premature baby boys have the condition, according to the Nemours Foundation (Nemours). According to PubMed Health, an estimated three to four percent of non-premature baby boys also experience the condition (PubMed).
Excess fibrous tissue or muscles that will not stretch in the groin can cause an undescended testicle in some babies. A surgeon can correct these issues.
An undescended testicle can affect a man’s fertility if left untreated. The higher temperature inside the body can affect the testicle’s development and sperm production. Men with both testicles affected are more likely to experience fertility-related issues than men with only one affected testicle.
Men with an undescended testicle are more likely to have an inguinal hernia. This causes the intestine to push out through a weakened area in the abdominal wall. Only surgery can correct this painful condition.
The condition also can cause embarrassment due to feeling different.
According to the Nemours Foundation, a physician can palpate (feel) an undescended testicle in the abdomen in 70 percent of cases (Nemours).
However, the remaining 30 percent of cases may result in a testicle that cannot be felt. In some cases, the second testicle may not be present.
An X-ray or ultrasound imaging test may help to detect and confirm the diagnosis of the undescended testicle. Imaging scans, including an MRI with contrast, can confirm the presence or absence of the testicle.
Two conditions mimic undescended testicle. A retractile testicle is one that moves back and forth between the groin and the scrotum. This condition typically subsides as your child ages. An ascending testicle is one that returns to the groin and cannot be easily guided back.
The outlook for those with an undescended testicle is very good. The testicles will typically come down on their own by the time a child reaches six months of age. Your child’s physician will conduct a physical examination at that time. He or she may recommend testing if the testicles have not descended.
Hormones that stimulate testosterone production may be used to cause the testicle to descend. This involves injection of the hormone human chorionic gonadotropin (HCG). This treatment method has about a 20 percent success rate, according Docimo et al. (Docimo et al.) It is not as effective as surgery. Hormone treatment may lead to early puberty.
Your physician may recommend surgery if your child’s testicle or testicles have not descended by age one. The surgery is called orchiopexy. It is usually done as an outpatient procedure. This involves making a small incision in the groin to allow the testicle to descend to an appropriate position. Recovery typically takes about one week.
Sometimes extra tissue keeps the testicle from descending. A physician can remove the excess tissue if this is the case. In other cases, your child may need surgery to stretch the ligament that holds the testicle. This helps the testicle descend into a normal position. In some cases, the testicle is poorly developed or contains abnormal or non-viable tissue. If this is the case, the surgeon will completely remove this testicular tissue.
Surgeons typically remove the testicle in a man who has reached adulthood before having the condition treated. This is because the testicle is unlikely to produce sperm.