Undescended Testicle

The most common genital abnormality present at birth in male babies is cryptorchidism, or an undescended testicle.

About four percent of all boys are born with this condition, although the rate is much higher if the baby is born prematurely. Approximately thirty percent of premature boys will be born with cryptorchidism.

  • Most of the time, the testicle will descend on its own by the boy’s first birthday.
  • If not, surgical intervention is recommended.

What Causes an Undescended Testicle?

Testicles form in the abdomen during fetal development
Premature birth increases the likelihood of the condition
Testicles normally descend shortly before birth

The testicles are formed in the abdomen of a developing fetus. They do not usually descend into their correct position until shortly before birth, which is the reason premature babies are more at risk for the condition. Placement of the testicles is checked by the physician shortly after birth. If both testicles are not found, the baby is diagnosed with cryptorchidism. Further examination can determine if the testicle never formed, or if it has become shriveled from a blockage in the testicular vessels. These causes are rarer, however.

Testicle Position and Development

Undescended testicles may remain above the scrotum or in the abdomen. Normally, it is just a matter of the testicle not descending properly.
1
The testicle may be just above the scrotum or located in the abdomen.
2
If the testicle retracts again after being moved during an exam, it may be diagnosed as retractile.
3
A retractile testicle can move between the scrotum and groin. Retractile testicles usually resolve by puberty.
What Are the Risks of Not Fixing the Testicle?
Undescended testicles are more prone to twisting and injury
The condition may cause embarrassment for the child
The risk of testicular cancer is higher in affected boys
Proper placement allows easier monitoring for malignancy

In males, the scrotum keeps the testicles at a cooler temperature than the rest of the body. Higher temperatures in the abdomen can reduce the normal production of sperm, leading to fertility issues in the future.

How Can a Physician Fix an Undescended Testicle?

Surgery is recommended if the testicle does not descend
The testicle is surgically brought down and secured
The procedure used is called an orchiopexy
A small incision is made in the groin during surgery

In most cases, especially if there are no underlying causes that are initially seen, a physician will opt to observe the testicle for the first year of life. More than half of boys born with an undescended testicle will need no further intervention and the testicle will descend by the first birthday. If this hasn’t occurred by the age of one, the testicle will need to be surgically brought down and affixed into place.

Surgical Treatment
1
Orchiopexy Procedure
An orchiopexy is the surgical treatment of choice. A small cut is made into the groin, allowing the surgeon to pull the testicle down and into place.
2
Securing the Testicle
It is then fixed into place in the scrotum, or pexed.
3
Long-Term Outcome
A surgical fix of cryptorchidism should not need to be repeated later in life.