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Undescended testicles

4-minute read

Some baby boys are born with undescended testicles, where one or both testes is missing from the scrotum. The testicles often come down by themselves, but if they don’t appear by 6 months it’s important to get treatment to prevent future health problems. 

What are undescended testicles?

Testicles (testes) are the male sex glands that produce sperm and hormones. They form in the abdomen (tummy) of male babies while they are in the womb and usually descend (come down) into the scrotum during the eighth month of pregnancy.

Undescended testicles (also called cryptorchidism) refers to the condition when one or both testes have not descended into the scrotum by the time the baby is born. Alternatively, one or both testes may have partly come down, but not fully.

Cause of undescended testicles

In many babies, the cause of the undescended testes is unknown. In others, it may be caused by the baby being born prematurely, having a hormonal or genetic problem, or having low levels of androgens (male sex hormones).

Symptoms of undescended testicles

The main symptom is that one or two testes are missing from the baby’s scrotum. He will not experience any problems urinating or have any pain, unless the cord attaching the testes (spermatic cord) is twisted.

Undescended testes should not be confused with retractile testes, which occurs when the testes temporarily pull up into the groin when your baby or child is, say, cold or upset. They will return to the usual position when your baby is warm or content again.

At what age does undescended testicles occur?

Between 1 in 25 and 1 in 50 baby boys have 1 or 2 undescended testicles at birth. However, they usually move down into the scrotum by around 6 months of age. If the testicles have not descended by 6 months, they are unlikely to come down by themselves and an operation will be needed.

Sometimes a baby is born with his testes in his scrotum but they move up into the groin later. This can happen between the ages of 1 and 10 years old and is caused by the spermatic cord growing at a slower rate and pulling the testicles up as the child grows. This condition is called acquired undescended testes. 

What happens if this condition is not treated?

It’s important to treat undescended testes. If they haven’t descended it may affect the production of sperm in the future because the abdomen and groin are warmer than the scrotum. This difference in temperature, even in babies as young as 6 months, can cause fertility problems later in life.

Other issues that could arise include:

  • twisting of the spermatic cord, cutting off blood supply to the testes
  • an increased risk of testicular cancer (although this is uncommon, affecting fewer than 1 in 100 boys with undescended testes)
  • a hernia caused by some fat or a loop of bowel comingthrough the abdominal wall and possibly down towards the scrotum 
  • an increased risk of trauma and injury to the testes during normal activity
  • poor self-image due to the scrotum not looking normal

Diagnosis of undescended testicles

A diagnosis of undescended testicles is made once a doctor has done a physical examination. Alternatively, you may notice yourself that your baby’s testicles have disappeared from his scrotum.

Treatment for undescended testicles

If the testes don’t descend by themselves, or your child develops an undescended testicle, in most cases an operation, called orchiopexy will be recommended. During this procedure, the surgeon will gently stretch the cord and bring the testicle down into the scrotum. Your baby or child will be under anaesthesia and, in most cases, will be able to go home the same day.

Where to get help

If the testes don’t descend by themselves, or your child develops an undescended testicle, in most cases an operation, called an orchiopexy, will be recommended. During this procedure, the surgeon will gently stretch the cord and bring the testicle down into the scrotum. Your baby or child will be under anaesthesia and, in most cases, will be able to go home the same day.

Last reviewed: August 2018

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