17594 Undescended Testicles

Overview

An undescended testicle means one or both testicles have not moved down into the scrotum, the loose pouch of skin below the penis. This happens before birth. Usually the testicles drop into place by the time a baby is born, but sometimes one or both stay inside the belly or groin.

It is common, especially in babies born early. About 1 in 100 full-term baby boys and up to 1 in 3 premature boys have an undescended testicle at birth.

It affects baby boys. It can happen on one side or both sides. It is more common in premature babies and in boys with a family history of the condition.

Symptoms

Common symptoms

• The scrotum looks empty on one or both sides
• The testicle is not felt in the scrotum but may be felt higher up in the groin

Symptoms in children

• Parents may notice the scrotum is not full or round as expected
• A lump may be felt in the groin that is not in the scrotum

Symptoms in older adults

• Most undescended testicles are found in infancy, but if no treatment happened, an older male may notice an absent testicle or a mass

Causes

Main causes

• The exact cause is not fully understood
• Hormones and physical changes in the body guide the testicle from the belly to the scrotum before birth
• In some cases, a connection may block the path

Risk factors

• Premature birth
• Low birth weight
• Family history of undescended testicles
• Some conditions that affect growth or hormones

When to see a doctor

See a doctor urgently if:

• If your baby has a tender, red or swollen scrotum
• If your child has sudden severe pain in the groin or belly

Book a routine appointment if:

• If your baby's testicle is not in the scrotum by the routine check at 6 to 8 weeks
• If you have any concerns about the size or position of the testicles at any age

Diagnosis

A doctor will examine your baby or child. They will feel gently in the groin and scrotum to check if the testicle is there. Sometimes the testicle can be felt, and sometimes it is not in the groin and may be higher up.

Tests that may be done

• Physical examination of the scrotum and groin
• Ultrasound scan to find the testicle if it is not easily felt
• Hormone tests or other imaging if the testicle cannot be found

What to expect at your appointment

The doctor will ask about your baby's birth and otherwise health. The examination is simple and usually not painful. You may be asked to bring your baby for a second check at 3 months, because many testicles will come down by then.

Treatment

Treatment is usually not needed in the first few months, as many testicles move down naturally. If it has not descended by 3 to 6 months, your child will be referred to a specialist.

Self-care at home

• Keep routine check-up appointments so the doctor can track the position of the testicle
• Record any changes you notice, such as a testicle that appears and disappears

Medical treatments

For babies with undescended testicles that have not moved down by 6 months, the standard approach is a surgical procedure called orchidopexy. This moves the testicle into the scrotum and fixes it in place. Sometimes hormonal injections have been used, but surgery is the most effective and commonly used treatment.

When is surgery considered?

Surgery is usually done between 6 and 18 months of age. It helps preserve fertility and makes the testicle easier to examine for problems later.

Living with this condition

For parents, day-to-day care is simply bringing your baby to routine checks and watching for any swelling or pain. After surgery, your child may have a small wound that heals quickly.

Lifestyle tips

• Give children plenty of comfort and normal activities after surgery
• Follow the surgeon's advice about bathing and wound care
• Attend follow-up appointments to make sure the testicle stays in place

Diet and exercise

There are no specific foods or exercises that affect undescended testicles. A balanced diet and normal play are fine. After surgery, follow the doctor's advice about avoiding rough play for a few days.

Mental health and emotional wellbeing

For parents, this condition can cause worry. It may help to know that treatment is straightforward and successful. If your older child feels anxious about surgery, talk to them honestly and involve the medical team to answer questions.

Prevention

Undescended testicles cannot be prevented. It happens during development in the womb.

Screening programmes

Regular baby health checks include checking the testicles. There is no separate screening test needed.

Complications

If left untreated

• Risk of reduced fertility in adulthood
• Higher risk of testicular cancer (though still rare)
• Higher risk of inguinal hernia or testicular torsion

Long-term outlook

With early and proper treatment, the outlook is very good. Most boys who have surgery for undescended testicles grow up healthy with normal fertility. Testicular cancer risk is still slightly higher, but regular self-examination can help catch problems early.

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