Undescended testicle (cryptorchidism)
Definition:
Undescended testicle (cryptorchidism) is a testicle that hasn't moved into its proper position in the bag of skin hanging behind the penis (scrotum) prior to the birth of a baby boy. Usually just one testicle is affected, but in some cases both testes may be undescended.
An undescended testicle is more common among baby boys born prematurely or before 37 weeks.
For most boys born with one or two undescended testicles, the problem corrects itself within the first few months of life. If your infant has an undescended testicle that doesn't correct itself, surgery can usually be used to relocate it into the scrotum.
Symptoms:
Testicles form in the abdomen during fetal development. During the last couple of months of normal fetal development, the testicles gradually leave the abdomen, pass through a tube-like passageway in the groin (inguinal canal) and descend into the scrotum.
If your son has an undescended testicle, that process was stopped or delayed in some stage of development. Therefore, you won't see or feel a testicle where you would expect it to be in the scrotum.
When to see a doctor
An undescended testicle is typically detected when your baby is examined shortly after birth. If your son has an undescended testicle, ask the doctor how often your son will need to be examined. If the testicle hasn't moved into the scrotum by the time your son is 4 months old, the problem probably won't correct itself.
Treating undescended testicle when your son is still a baby may lower the risk of complications later in life, such as infertility and testicular cancer.
Older boys — from infants to pre-adolescent boys — who have normally descended testicles at birth may appear to be "missing" a testicle later. This condition may indicate:
Causes:
The exact cause of an undescended testicle isn't known. A combination of genetics, maternal health and other environmental factors may disrupt the hormones, physical changes and nerve activity that influence the development of the testicles.
Complications:
In order for testicles to develop and function normally, they need to be slightly cooler than normal body temperature. The scrotum provides this cooler environment. Until a boy is 3 or 4 years old, the testicles continue to undergo changes that affect how well they function later.
An undescended testicle isn't in a cooler environment. This might increase the risk of complications later in life. These complications include:
The goal of treatment is to move the undescended testicle to its proper location in the scrotum. Early treatment may lower the risk of complications of an undescended testicle, such as the risk of infertility and testicular cancer.
Surgery
An undescended testicle is usually corrected with surgery. The surgeon carefully manipulates the testicle into the scrotum and stitches it into place. This procedure usually requires relatively small incisions and may be performed with laparoscopic devices.
When your son has surgery will depend on a number of factors, such as your son's health and how difficult the procedure might be. Your surgeon will likely recommend doing the surgery after your son is 3 to 6 months old and before he is 15 months old. Early surgical treatment appears to lower the risk of later complications.
In some cases, the testicle may be poorly developed, abnormal or dead tissue. The surgeon will remove this testicular tissue.
If your son also has an inguinal hernia associated with the undescended testicle, the hernia is repaired during the surgery.
After surgery, the surgeon will monitor the testicle to see that it continues to develop, function properly and stay in place. Monitoring may include:
Hormone treatment involves the injection of human chorionic gonadotropin (HCG). This hormone could cause the testicle to move to your son's scrotum, but hormone treatment is usually less effective than surgery is. There's some evidence that hormone treatment may contribute to early onset of puberty (precocious puberty).
Other treatments
If your son doesn't have one or both testicles — either missing or didn't survive after surgery — you may consider saline testicular implants for the scrotum that can be implanted during late childhood or adolescence. These implants — testicle-shaped nodules filled with a fluid — result in the "appearance" of two testicles in the scrotum.
If your son doesn't have at least one healthy testicle, your doctor will refer you to a hormone specialist (endocrinologist) to discuss future hormone treatments that would be necessary to bring about puberty and physical
Definition:
Undescended testicle (cryptorchidism) is a testicle that hasn't moved into its proper position in the bag of skin hanging behind the penis (scrotum) prior to the birth of a baby boy. Usually just one testicle is affected, but in some cases both testes may be undescended.
An undescended testicle is more common among baby boys born prematurely or before 37 weeks.
For most boys born with one or two undescended testicles, the problem corrects itself within the first few months of life. If your infant has an undescended testicle that doesn't correct itself, surgery can usually be used to relocate it into the scrotum.
Symptoms:
Testicles form in the abdomen during fetal development. During the last couple of months of normal fetal development, the testicles gradually leave the abdomen, pass through a tube-like passageway in the groin (inguinal canal) and descend into the scrotum.
If your son has an undescended testicle, that process was stopped or delayed in some stage of development. Therefore, you won't see or feel a testicle where you would expect it to be in the scrotum.
When to see a doctor
An undescended testicle is typically detected when your baby is examined shortly after birth. If your son has an undescended testicle, ask the doctor how often your son will need to be examined. If the testicle hasn't moved into the scrotum by the time your son is 4 months old, the problem probably won't correct itself.
Treating undescended testicle when your son is still a baby may lower the risk of complications later in life, such as infertility and testicular cancer.
Older boys — from infants to pre-adolescent boys — who have normally descended testicles at birth may appear to be "missing" a testicle later. This condition may indicate:
- A retractile testicle, which moves back and forth between the scrotum and the groin and may be easily guided by hand into the scrotum during a physical examination
- An ascending testicle, or acquired undescended testicle, which has "returned" to the groin and cannot be easily guided by hand into the scrotum
Causes:
The exact cause of an undescended testicle isn't known. A combination of genetics, maternal health and other environmental factors may disrupt the hormones, physical changes and nerve activity that influence the development of the testicles.
Complications:
In order for testicles to develop and function normally, they need to be slightly cooler than normal body temperature. The scrotum provides this cooler environment. Until a boy is 3 or 4 years old, the testicles continue to undergo changes that affect how well they function later.
An undescended testicle isn't in a cooler environment. This might increase the risk of complications later in life. These complications include:
- Testicular cancer. Testicular cancer usually begins in the cells in the testicle that produce immature sperm. What causes these cells to develop into cancer is unknown. Men who've had an undescended testicle have an increased risk of testicular cancer. Surgically correcting an undescended testicle before age 15 months may decrease, but not eliminate, the risk of future testicular cancer.
- Fertility problems. Low sperm counts, poor sperm quality and decreased fertility are more likely to occur among men who have had an undescended testicle.
- Testicular torsion. Testicular torsion is the twisting of the spermatic cord, which contains blood vessels, nerves and the tube that carries semen from the testicle to the penis. This painful condition cuts off blood to the testicle. If not treated promptly, it may result in the loss of the testicle. An undescended testicle increases the risk of testicular torsion.
- Trauma. If a testicle is located in the groin, it may be damaged from pressure against the pubic bone.
- Inguinal hernia. An undescended testicle may be associated with an inguinal hernia. If the opening between the abdomen and the inguinal canal is too loose, a portion of the intestines can push into the groin.
The goal of treatment is to move the undescended testicle to its proper location in the scrotum. Early treatment may lower the risk of complications of an undescended testicle, such as the risk of infertility and testicular cancer.
Surgery
An undescended testicle is usually corrected with surgery. The surgeon carefully manipulates the testicle into the scrotum and stitches it into place. This procedure usually requires relatively small incisions and may be performed with laparoscopic devices.
When your son has surgery will depend on a number of factors, such as your son's health and how difficult the procedure might be. Your surgeon will likely recommend doing the surgery after your son is 3 to 6 months old and before he is 15 months old. Early surgical treatment appears to lower the risk of later complications.
In some cases, the testicle may be poorly developed, abnormal or dead tissue. The surgeon will remove this testicular tissue.
If your son also has an inguinal hernia associated with the undescended testicle, the hernia is repaired during the surgery.
After surgery, the surgeon will monitor the testicle to see that it continues to develop, function properly and stay in place. Monitoring may include:
- Physical exam
- Ultrasound examination of the scrotum
- Tests of hormone levels
Hormone treatment involves the injection of human chorionic gonadotropin (HCG). This hormone could cause the testicle to move to your son's scrotum, but hormone treatment is usually less effective than surgery is. There's some evidence that hormone treatment may contribute to early onset of puberty (precocious puberty).
Other treatments
If your son doesn't have one or both testicles — either missing or didn't survive after surgery — you may consider saline testicular implants for the scrotum that can be implanted during late childhood or adolescence. These implants — testicle-shaped nodules filled with a fluid — result in the "appearance" of two testicles in the scrotum.
If your son doesn't have at least one healthy testicle, your doctor will refer you to a hormone specialist (endocrinologist) to discuss future hormone treatments that would be necessary to bring about puberty and physical
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