What are Undescended Testicles?

Testicles are organs that hang in a sac below the penis (the scrotum). Sperm and testosterone are made in the testicles, where they are kept at a cooler temperature than the rest of the body.

As a boy grows inside a mother’s womb, his testicles form inside his abdomen and descend or drop into the scrotum shortly before birth. When the testicles don’t descend, the baby has cryptorchidism or, undescended testicles. This is a congenital condition (present at birth) and the most common abnormality in male babies – approximately 30% of premature babies and 4% of term babies are born with this. Typically, just one testicle is undescended, but in approximately 10% of cases, both testicles are undescended.

Near the end of pregnancy, testicles begin to descend to the scrotum. A path is cleared for the testicles and they follow the back wall of the hernia into the scrotum, the hernia then closes. Sometimes the process does not finish and the testicle can end up anywhere between the abdomen to above the scrotum.

Doctors aren’t certain what causes undescended testicles, but it can be genetic and run in some families. If a boys older brother was born with undescended testicles, a child is twice as likely to experience the same condition. Low birth weight (associated with premature birth) and down syndrome can lead to undescended testicles. Most babies born with the condition are otherwise completely healthy.

About fifty to seventy five percent of undescended testicles will drop on their own before the baby is 3 months old. However, after 3 months the testicles will not drop and treatment will be needed. Testicles that do not drop soon enough won’t work normally – testicles must be in the scrotum where the temperature is 2-3 degrees cooler than the body to make sperm. Undescended testicles can lead to infertility, an increased risk of testicular cancer, increased risk of a hernia, testosterone deficiency, and a higher risk of trauma.

Undescended testicles don’t cause any pain or cause any symptoms and urination is not affected. The condition is detected during the newborn examination immediately after birth or during a routine checkup at six to eight weeks. You will notice a testicle is undescended because the scrotum looks smoother, smaller, and flatter on the side without a testicle. You also won’t be able to feel the round-shaped testicle.

Retractile Testicles

Retractile testicles are not the same as undescended testicles. As a boy is scared, excited, or cold, testicles can move in and out of the scrotum. This is not a cause for concern because typically the testicles settle into the scrotum as boys age. However, it should be monitored to ensure they do in fact descend back into the scrotum. If your child’s testicles are not in the scrotum, contact a doctor.

If your child is born with undescended testicles, treatment typically involves surgery and is performed before the child turns one year old in order to lower the risk of fertility issues and testicular cancer later in life. Hormone therapy may be used if the testicle is close to the scrotum (and not in the abdomen).

If your child has an undescended testicle, seeing a doctor as soon as possible is recommended so as to save the testicle and help the child maintain his fertility.