What Happens If You Have an Undescended Testicle?
Key takeaways:
Most male babies are born with both testicles in the scrotum. An undescended testicle is one that hasn’t yet dropped down into the proper place.
After a baby is born, sometimes it takes a few months for one or both testicles to descend into place.
A testicle that doesn’t move into place on its own needs treatment. This helps to protect future health and fertility.
An undescended testicle, or cryptorchidism, is when one or both testicles aren’t in the usual place in the scrotum. The scrotum is the sac below the penis that holds the testicles. For most male babies, the testicles are already in the scrotum at birth. Others descend a few months after birth. Some babies will need treatment to bring the testicle into the correct position. It’s best for the health of the child if this happens before their first birthday. Read on to find out what happens if you or your child has an undescended testicle.
What causes an undescended testicle?
When a genetically male fetus is growing, the testicles first start developing in the abdomen. Toward the end of the pregnancy, certain hormones signal the testicles to descend down through the abdomen and into the scrotum. But this final step in the process doesn’t always happen before birth. Experts aren’t exactly sure why, but they think it’s related to abnormal hormone levels.
Like many health conditions, the cause of an undescended testicle is probably a combination of genes and something in the environment. While we don’t know for sure what causes this condition, there are a few risk factors that may make it more likely for a baby to be born with it:
Prematurity, or being born before 37 weeks of pregnancy
Low birth weight, or babies who are born small
Exposure to cigarette smoke during pregnancy
Family history of an undescended testicle
Exposure to pesticides, heavy metals, or phthalates during pregnancy
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How common are undescended testicles?
Undescended testicles aren’t that common. Only about 4 in 100 male infants are born with an undescended testicle. But this increases to more than 20 in 100 for those who are born prematurely.
Most babies with this condition only have one undescended testicle. But about 20% to 30% of the time, neither testicle has fully descended. These infants may need more tests to look for genetic and hormonal changes that may be affecting them.
How do you diagnose an undescended testicle?
Babies have routine newborn exams to check on all aspects of their health and growth. A healthcare provider usually diagnoses an undescended testicle when they examine the baby and can’t feel the testicle in the scrotum.
Sometimes a baby has a retractile testicle, not an undescended one. This is when a baby’s testicles pull up into the body with cold or stress. So it helps to examine the scrotum when the baby is warm and relaxed.
If a testicle can’t be felt in the scrotum, it may be felt above it. Some undescended testicles are still high in the abdomen. But others may be on their way down and can be felt in the groin.
If the testicle can’t be felt in the scrotum by the time the infant is a few months old, their primary care provider will recommend an appointment with a specialist before 6 months of age. Pediatric urologists are doctors who specialize in conditions like this.
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Most of the time, a trained healthcare provider can find the position of the testicle without further tests. Sometimes they’ll do a test like an ultrasound, MRI, or CT scan. But these tests may not be helpful. The American Urological Association doesn’t recommend doing them before a specialist sees the baby. If the location of the testicle isn’t clear, a surgical procedure is the only way to know for sure.
How do you treat an undescended testicle?
The good news is that most undescended testicles move into place on their own. This usually happens in the first 3 months of life. Only 1 or 2 of every 100 infants with this condition will need treatment.
The main treatment for an undescended testicle is an orchiopexy surgery. A surgeon usually does this when a child is between 6 months and 1 year of age. The surgeon moves the testicle into the correct place in the scrotum. This kind of surgery works about 98% of the time.
Before surgery, sometimes healthcare providers will first try B-hcg, a hormone injection. But this treatment is less common and isn’t as successful as surgery.
How serious is an undescended testicle?
You may be wondering why it’s necessary to get a testicle into its usual place in the scrotum. Besides the possible effects on a child’s relationship with their body as they get older, there are some other important health conditions to consider:
Higher risk of testicular cancer: This risk may be two to eight times higher in those who have an undescended testicle, or had one in the past.
Fertility problems: A testicle that isn’t in the scrotum is too warm to make sperm. About 10% of people born male who experience infertility have a history of an undescended testicle. This rate is higher if both testicles are undescended or if the person has surgery at a later age.
Higher risk of torsion: This is a painful twisting of the testicle that affects the blood supply to the testicle.
Higher risk of inguinal hernia: This kind of hernia causes pain or swelling when the intestines push into the groin. Surgeons often repair it at the same time as the orchiopexy.
The bottom line
If a baby is born with an undescended testicle, it’s not something to worry about immediately. But you should pay close attention to it. An undescended testicle often moves into the scrotum on its own. But if this doesn’t happen within a few months, the child may need surgery to move the testicle to the right location. This helps to protect the health and fertility of a child as they get older.
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References
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Gurney, J. K., et al. (2017). Risk factors for cryptorchidism. Nature Reviews. Urology.
Kolon, T. F., et al. (2014). Evaluation and treatment of cryptorchidism: AUA guideline. The Journal of Urology.
Kurz, D. (2016). Current management of undescended testes. Current Treatment Options in Pediatrics.
Leslie, S. W., et al. (2022). Cryptorchidism. StatPearls.
MedlinePlus. (2022). Undescended testicle.
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Pettersson, A., et al. (2007). Age at surgery for undescended testis and risk of testicular cancer. New England Journal of Medicine.
Sepúlveda, X., et al. (2016). Current management of non-palpable testes: A literature review and clinical results. Translational Pediatrics.
UPMC Children’s Hospital of Pittsburgh. (n.d.). Undescended testicle (orchiopexy) repair surgery.
Urology Care Foundation. (n.d.). What are undescended testicles (cryptorchidism)?
