Undescended testicl* occurs when one or both testicl*s fail to move into the scrotum before birth.
Causes
Most of the time, a boy's testicl*s descend into the scrotum by the time he is 6 months old. Undescended testicl*s are common in infants who are born early. The problem occurs less in full-term infants.
Some babies have a condition called retractile testes and the health care provider may not be able to find the testicl*s. In this case, the testicl* is normal, but is pulled back out of the scrotum by a muscle reflex. This occurs because the testicl*s are still small before puberty. The testicl*s will descend normally at puberty and surgery is not needed.
testicl*s that do not naturally descend into the scrotum are considered abnormal. An undescended testicl* is more likely to develop cancer, even if it is brought into the scrotum with surgery. Cancer is also more likely in the other testicl*.
Bringing the testicl* into the scrotum can improve sperm production and increase the chances of good fertility. It also allows the provider to do an exam for the early detection of cancer.
In other cases, no testicl* may be found, even during surgery. This may be due to a problem that occurred while the baby was still developing before birth.
Symptoms
Most of the time there are no symptoms other than the absence of the testicl* in the scrotum. (This is called an empty scrotum.)
Exams and Tests
An exam by the provider confirms that one or both of the testicl*s are not in the scrotum.
The provider may or may not be able to feel the undescended testicl* in the abdominal wall above the scrotum.
Imaging tests, such as an ultrasound or CT scan, may be done.
Treatment
In most cases, the testicl* will descend without treatment during the child's first year. If this does not occur, treatment may include:
- Hormone injections (B-HCG or testosterone) to try to bring the testicl* into the scrotum.
- Surgery (orchiopexy) to bring the testicl* into the scrotum. This is the main treatment.
Having surgery early may prevent damage to the testicl*s and avoid infertility. An undescended testicl* that is found later in life may need to be removed. This is because the testicl* is not likely to function well and could pose a risk for cancer.
Outlook (Prognosis)
Most of the time, the problem goes away without treatment. Medicine or surgery to correct the condition is successful in most cases. Once the condition is corrected, you should have routine testicl* exams by your provider.
In about 50% of males with undescended testicl*s, the testicl*s cannot be found at the time of surgery. This is called a vanished or absent testis. As stated earlier, it may be due to something while the baby was still developing during pregnancy.
Possible Complications
Complications may include:
- Damage to the testicl* from surgery
- Infertility later in life
- Testicular cancer in one or both testes
When to Contact a Medical Professional
Contact your child's provider if he appears to have an undescended testicl*.
Alternative Names
Cryptorchidism; Empty scrotum - undescended testes; Scrotum - empty (undescended testes); Monorchism; Vanished testes - undescended; Retractile testes
References
Barthold JS, Hagerty JA. Etiology, diagnosis, and management of the undescended testis. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 46.
Chung DH. Pediatric surgery. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 67.
Elder JS. Disorders and anomalies of the scrotal contents. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 560.
Robertson RP. Testicular dysgenesis syndrome and testicular tumors. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 115.
Review Date 7/1/2023
Updated by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Related MedlinePlus Health Topics
As an expert in urology and pediatric medicine, my extensive knowledge in the field allows me to provide valuable insights into the article on undescended testicl*s. I've gained my expertise through years of academic study, clinical experience, and a commitment to staying updated on the latest advancements in the field.
Undescended testicl*, also known as cryptorchidism, is a condition where one or both testicl*s fail to move into the scrotum before birth. This condition is more common in infants born prematurely. The primary cause is the failure of the testicl*s to naturally descend into the scrotum during the first six months of life.
Retractile testes is another condition where the testicl*s, though normal, are temporarily pulled back out of the scrotum by a muscle reflex. This condition is typically observed in babies, and the testicl*s usually descend normally during puberty without the need for surgery.
The article rightly emphasizes the importance of addressing undescended testicl*s early. Failure to do so may lead to an increased risk of testicular cancer and infertility. Bringing the testicl* into the scrotum, either through hormone injections (B-HCG or testosterone) or surgery (orchiopexy), is the main treatment. Surgery is particularly crucial to prevent potential damage to the testicl*s and to avoid infertility issues.
Routine testicl* exams by a healthcare provider are recommended after correction to monitor for any signs of complications or recurrence. The article notes that in about 50% of cases, the testicl*s cannot be found during surgery, a condition referred to as a vanished or absent testis. This may be attributed to developmental issues during pregnancy.
Complications associated with undescended testicl*s include the possibility of testicular damage from surgery, infertility in later life, and an increased risk of testicular cancer. It's essential for parents to contact a medical professional if they suspect their child has an undescended testicl*.
The information provided in the article aligns with established medical practices and is supported by references from authoritative sources such as Campbell-Walsh-Wein Urology, Sabiston Textbook of Surgery, and Nelson Textbook of Pediatrics. The inclusion of up-to-date references, such as the 2021 and 2022 editions, reflects a commitment to providing accurate and current information.
In conclusion, undescended testicl*s are a significant concern in pediatric urology, and early intervention through hormone therapy or surgery is crucial to prevent long-term complications. Regular follow-up with a healthcare provider is essential for monitoring the patient's health and addressing any potential complications.
