Undescended Testicles

What are undescended testicles?

During fetal development, the testicles develop in the abdomen. Testicles make and store sperm sex cells. Before birth, the testicles typically drop from inside the abdomen into the scrotum. The scrotum is the thin pouch of skin behind the penis that normally holds the testicles. Undescended testicles are when the testicles fail to drop into the scrotum before birth or in the first few months of life.

Another name for undescended testicles is cryptorchidism.

Are undescended testicles serious?

Without treatment, undescended testicles can be serious. They can lower your child’s testosterone levels and affect their sperm health. With or without treatment, your child may also have a slightly increased risk of developing testicular cancer. But earlier treatment decreases this increased risk.

How common are undescended testicles?

About 3% of babies have undescended testicles at birth. However, undescended testicles are more common in premature babies. Up to 30% of premature babies have undescended testicles.

In about half of babies who have undescended testicles, the testicles will descend on their own within a few months.

What are the symptoms of undescended testicles?

The main symptom of undescended testicles is the absence of a testicle in one or both sides of the scrotum. There are usually no other symptoms. Undescended testicles don’t cause pain or affect your baby’s ability to urinate (pee).

What causes undescended testicles?

Healthcare providers and medical researchers aren’t sure why some babies have undescended testicles at birth. In some cases, they think a testosterone deficiency during fetal development may interfere with how the testicles develop.

There isn’t any evidence that anything a pregnant person does during pregnancy causes a baby to have undescended testicles.

Who do undescended testicles affect?

Undescended testicles can affect any baby assigned male at birth (AMAB). However, undescended testicles are more common in premature babies who haven’t had a full nine months to develop before birth.

What are the complications of undescended testicles?

Babies with undescended testicles have a higher risk of:

• Testicular cancer. Testicular cancer is the most common cancer that affects people AMAB between 15 and 35.
• Testicular torsion. Testicular torsion is when the spermatic cord twists and cuts off the blood supply to a testicle. It’s very painful, and a testicle may die without immediate treatment.
• Inguinal hernia. An inguinal hernia is a type of hernia. Part of an organ bulges through muscle or tissue near your groin.
• Hypogonadism. Hypogonadism is when your testicles don’t produce enough testosterone.

How are undescended testicles diagnosed?

Your child’s healthcare provider can diagnose undescended testicles during a physical examination at birth or shortly after birth. If they can’t feel the testicles (impalpable), your child may have undescended testicles.

The provider may refer you to a pediatric urologist. A pediatric urologist is a surgeon who specializes in diseases and conditions that affect the urinary and reproductive systems in children. They may order imaging tests, including a pelvic ultrasound, to help locate the testicles. However, an ultrasound usually isn’t necessary.

How are undescended testicles corrected?

An orchiopexy is the gold-standard undescended testicle treatment. During an orchiopexy, a surgeon will make a small cut (incision) in your child’s groin and locate the undescended testicles in the abdomen. They’ll also make a small incision in your child’s scrotum and create pockets to hold the testicles in place. If they discover the undescended testicles don’t work, they may remove them.

At what age should undescended testicles be treated?

If your child’s testicles haven’t dropped by the time they’re 6 months old, talk to a healthcare provider about treatment. If your child needs an orchiopexy, providers recommend they get it between 12 and 24 months of age.

What happens if cryptorchidism is not treated?

If testicles don’t drop into the scrotum, they may not function properly or produce healthy sperm. They can cause infertility later in life.

Can undescended testicles be prevented?

There’s no known way to prevent undescended testicles.

What can I expect if my child has undescended testicles?

Surgery to fix undescended testicles has a high success rate — about 98% effective. In most cases, the testicles develop normally in the scrotum and produce healthy sperm later in life.

If your child has undescended testicles, they have a slightly higher risk of testicular cancer. As they reach their teenage years, they should perform monthly testicular examinations and schedule regular checks with their healthcare provider.

How do I take care of my child if they have undescended testicles?

You may experience a lot of emotions if your child needs surgery to fix undescended testicles. But learning about the procedure and asking your child’s healthcare provider questions can help you remain calm, which can help your child relax.

It’s a good idea to pay attention to your tone of voice and facial expressions. Babies can recognize your emotions, which may cause them to feel fear or stress. When you’re relaxed, your child may feel calmer. You can help your child relax before surgery by reading their favorite book or letting them play with their favorite toys.

When should I see a healthcare provider?

Talk to your child’s healthcare provider if your child’s testicles haven’t descended after six months. After treatment to correct undescended testicles, call a provider if your child has:

• Heavy bleeding at the surgical site.
• Signs of infection, including skin discoloration, fever, chills, or fatigue.
• Severe pain in their groin.

What questions should I ask a healthcare provider?

Questions you may want to ask your provider include:

• Does my child need treatment for their undescended testicles?
• At what age should my child receive treatment?
• What’s the complete list of surgical risks?
• What’s the complete list of hormonal therapy risks?
• How long will it take my child to recover after treatment?
• Are there any long-term effects I should be aware of?

At what age should cryptorchidism end?

Talk to a healthcare provider if your child’s testicles don’t descend by the time they’re 6 months old.

Can you still have kids with one undescended testicle?

Yes, you can still have biological children if you have an undescended testicle. If you have one undescended testicle, your fertility rate is similar to those without an undescended testicle. If you have two missing testicles (bilateral undescended testicles), your fertility rate is lower.

Can you push an undescended testicle down?

No, you can’t push an undescended testicle down into the scrotum.

What is the difference between retractile testicles and undescended testicles?

Retractile testicles are when one or both testicles move back and forth between the groin and scrotum due to a muscle reflex. The muscle normally holds your testicles in place. But it can sometimes overreact to a stimulus like fear or touch and pull one or both testicles into your groin. Retractile testicles usually go away without treatment by the time your child reaches puberty.

A note from Cleveland Clinic

It can be overwhelming to hear that your child’s testicles haven’t descended. But it’s important to remember that undescended testicles are relatively common. They don’t cause your baby pain, and treatment is available and highly successful. Undescended testicles are more common in premature babies but can also affect full-term infants. If you have any questions, talk to your child’s healthcare provider. They’re here to help.