What are undescended testicles?

Also known as cryptorchidism, undescended testicles is a condition where one or both of a boy’s testicles aren’t in the scrotum where they’re supposed to be.  About 1-3% of term babies will have this.

Wait, why would they be somewhere else?

They start out someplace else.  While a baby boy is developing in the uterus his testicles start out in the lower belly.  Then, by 36 weeks of development, they have finished moving from there down into the scrotum.  

What causes undescended testicles?

It’s not known what causes the majority of undescended testicles.  In some cases there is something wrong with the testicle, or there’s a physical reason it can’t move.  Occasionally the blood supply is cut off so the tissues of the tesicle die.  Rarely, the testicle starts out in the scrotum at birth, but then isn’t stuck down properly, and moves back up after a few months or years.  Since the testicles don’t move until later in pregnancy, premature babies are more likely to have undescended testes.

How are they diagnosed?

Undescended testicles are diagnosed by checking for them during the physical exam.  Your pediatrician will check the scrotum for both testicles, and if not found there, will then feel the groin to see if they are laying higher up.  Testicles that can be pulled back down to the scrotum are called ‘retractile’, and aren’t usually a problem.  Testicles that can’t be pulled down to the scrotum are considered undescended.  If the testicle is still not found, then it may be in the belly.  

How are undescended testicles fixed?

If your child has undescended testes or one that cannot be found, your pediatrician will refer you to a pediatric surgeon or urologist (a surgeon that only deals with the urinary system).  The surgeon then will move the testicle back to the scrotum and sew it into place.  If there is a hernia, it will be fixed at that time, as well.  Sometimes, if the testicle is in the belly, then it may take two surgeries.  These surgeries are usually done about 6 months old, or when it is discovered.    

What happens if it’s not fixed?

Undescended testicles are at a slightly higher risk for cancer, and the risk goes up if surgery is postponed.  There is a risk to fertility if the testicle is not moved to the slightly cooler scrotum.   

Links.

Undescended testicles at kidshealth.

Undescended testicles at healthychildren.org.