For Parents

The Facts on Undescended Testicles

As a baby boy grows inside his mother's womb, his testicles typically form inside his abdomen and move down into the scrotum shortly before birth. But in some cases, that move doesn't occur and the infant is born with undescended testicles. The medical term for this is cryptorchidism.

The condition affects approximately 30% of baby boys who are born prematurely and about 3% of newborn boys who are carried to term.

In about half of the cases, undescended testicles move down on their own by the baby's first birthday. If this doesn't happen, it's important to get treatment because testicles that remain undescended can hurt the child's fertility down the line and lead to other medical problems.

Doctors can detect undescended testicles shortly after a baby is born. It may not cause your child any pain, but it may create swelling or a lump in his groin area. If you notice this, it's a good idea to call the doctor. Even if it's not an undescended testicle, it could be some other problem, such as a hernia, that requires medical attention.

How Is an Undescended Testicle Diagnosed?

Doctors usually diagnose cryptorchidism during an exam at birth or at a checkup shortly thereafter. If the infant has this condition, the doctor may not be able to feel one or both of the testicles in the scrotum, and the testicle may appear to be missing or lopsided.

Some babies are also born with a retractile testicle, which resides in the scrotum but on occasion temporarily retracts or pulls back up into the groin or the abdomen. Usually, there's no need to treat a retractile testicle, and it corrects itself before adolescence.

How Is It Treated?

If a baby's testicle has not descended on its own within the first year of life, a child usually is treated, typically with surgery, to correct the condition.

Treatment is necessary for several reasons:

• The higher temperature of the body may inhibit the normal production of sperm in the undescended testicle, which could lead to infertility.
• The undescended testicle is more susceptible to a tumor.
• The undescended testicle is more vulnerable to injury.
• An asymmetrical or empty scrotum may cause a child worry and embarrassment.
• Sometimes boys with undescended testicles develop hernias.

If the doctors recommend surgery for your child, it's likely that they will suggest a procedure called an orchiopexy, in which a small cut is made in the groin, and the testicle is brought down into the scrotum. Doctors typically do the surgery on an outpatient basis, and at most your child will probably recover fully within a week.

After treatment, a child who had a single undescended testicle usually regains full fertility potential and testicle function. A child who had two undescended testicles is more likely to have diminished fertility down the line.

If your son is treated for an undescended testicle as a baby, it's a good idea to let him know about it when he is older so that he can get proper follow-up care. It is important for all boys - even those whose testicles have properly descended - to learn how to do a testicular self-exam when they are teenagers so that they can detect any lumps or bumps that might be early signs of medical problems.

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