Undescended testicle (cryptorchidism)
Undescended testicle (cryptorchidism)
Undescended testicle (cryptorchidism) is a testicle that hasn't moved into its proper position in the bag of skin hanging below the penis (scrotum) before birth. Usually just one testicle is affected, but about 10 percent of the time, both testicles are undescended.
An undescended testicle is uncommon in general, but quite common among baby boys born prematurely.
The vast majority of the time, the undescended testicle moves into its proper position on its own, within the first few months of life. If your son has an undescended testicle that doesn't correct itself, surgery can relocate the testicle into the scrotum.
Not seeing or feeling a testicle where you would expect it to be in the scrotum is the main sign of an undescended testicle.
Testicles form in the abdomen during fetal development. During the last couple of months of normal fetal development, the testicles gradually descend from the abdomen through a tube-like passageway in the groin (inguinal canal) into the scrotum. With an undescended testicle, that process stops or is delayed.
When to see a doctor
Treating undescended testicle when your son is still a baby may lower the risk of complications later in life, such as infertility and testicular cancer.
Older boys — from infants to pre-adolescent boys — who have normally descended testicles at birth might appear to be "missing" a testicle later. This condition might indicate:
If you notice any changes in your son's genitals or are concerned about his development, talk to your son's doctor.
The exact cause of an undescended testicle isn't known. A combination of genetics, maternal health and other environmental factors might disrupt the hormones, physical changes and nerve activity that influence the development of the testicles.
Factors that might increase the risk of undescended testicle in a newborn include:
In order for testicles to develop and function normally, they need to be slightly cooler than normal body temperature. The scrotum provides this cooler environment. Until a boy is 3 or 4 years old, the testicles continue to undergo changes that affect how well they function later.
Complications of a testicle not being located where it is supposed to be include:
Other complications related to the abnormal location of the undescended testicle include:
Preparing for your appointment
An undescended testicle is usually detected at birth. Your family doctor or pediatrician will continue to monitor the condition during regularly scheduled exams, or well-baby visits, for your infant son.
To prepare for your appointment, write down a list of questions to discuss with your doctor. Questions might include:
Don't hesitate to ask additional questions during your appointment.
What to expect from your doctor
If your doctor feels the testicle somewhere in the inguinal canal, he or she will attempt to move it gently into the scrotum. If it moves only partway into the scrotum, if the movement appears to cause pain or discomfort, or if the testicle immediately retreats to its original location, it may be an undescended testicle. If the testicle can be moved relatively easily into the scrotum and remain there for a while, it's most likely a retractile testicle.
If your son's testicle hasn't descended or can't be located by the time your son reaches 3 or 4 months of age, your doctor should refer you to a specialist in children's genital and urinary tract disorders (pediatric urologist) or a pediatric surgeon for further examination.
Tests and diagnosis
If your son has an undescended testicle, his doctor may recommend surgery for diagnosis and potential treatment:
Treatments and drugs
The goal of treatment is to move the undescended testicle to its proper location in the scrotum. Early treatment (before 1 year of age) might lower the risk of complications of an undescended testicle, such as infertility and testicular cancer.
When your son has surgery will depend on a number of factors, such as your son's health and how difficult the procedure might be. Your surgeon will likely recommend doing the surgery after your son is 3 to 6 months old and before he is 12 months old. Early surgical treatment appears to lower the risk of later complications.
In some cases, the testicle may be poorly developed, abnormal or dead tissue. The surgeon will remove this testicular tissue.
If your son also has an inguinal hernia associated with the undescended testicle, the hernia is repaired during the surgery.
After surgery, the surgeon will monitor the testicle to see that it continues to develop, function properly and stay in place. Monitoring might include:
If your son doesn't have at least one healthy testicle, your doctor will refer you to a hormone specialist (endocrinologist) to discuss future hormone treatments that would be necessary to bring about puberty and physical maturity.
Lifestyle and home remedies
Even after corrective surgery, it's important to check the condition of the testicles to ensure they develop normally. You can help your son by being aware of the development of his body. Check the position of his testicles regularly during diaper changes and baths.
As your son gets older, talk to him about his testicles. When he's about to reach puberty and you're talking about what physical changes to expect, explain how he can check the testicles himself. Self-examination of testicles will be an important skill for early detection of possible tumors.
Coping and support
If your son doesn't have one or both testicles, he might be sensitive about his appearance. He might have anxieties about looking different from friends or classmates, especially if he has to undress in front of others in gym class. The following strategies might help him cope:
Last Updated: 2013-04-11
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