Undescended testicle (cryptorchidism)
Undescended testicle (cryptorchidism)
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.
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
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:
If you notice any changes in your son's genitals or are concerned about his development, talk to your doctor.
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.
Low birth weight and premature birth are the best understood risk factors that may increase the likelihood of undescended testicle in a newborn. Other risk factors are not as well understood. Conditions that may increase the risk include:
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:
Other complications related to the abnormal location of the undescended testicle include:
Preparing for your appointment
An undescended testicle is usually detected at birth. Therefore, your family doctor or pediatrician will continue to monitor the condition during regularly scheduled examinations, or well-baby visits, for your infant son.
Because appointments can be brief and there are often a number of questions to address during infant checkups, it's a good idea to be well prepared for your appointment. Write down a list of questions to discuss with your doctor. Questions regarding an undescended testicle might include:
The best time to your ask questions is at the beginning of the appointment, but don't hesitate to ask additional questions during your appointment.
What to expect from your doctor
If your doctor feels the testicle somewhere in the inguinal canal, he or she will attempt to move it gently into the scrotum. If it moves only partway into the scrotum, if the movement appears to cause pain or discomfort, or if the testicle immediately retreats to its original location, it's considered an undescended testicle. If the testicle can be moved relatively easily into the scrotum and remain there for a while, it's most likely a retractile testicle.
If your son's testicle hasn't descended or can't be located by the time your son reaches 3 or 4 months of age, your doctor will likely refer you to a specialist in children's genital and urinary tract disorders (pediatric urologist) or a pediatric surgeon for further examination.
Tests and diagnosis
Your doctor can easily determine that a testicle hasn't descended into the scrotum. The goal of further examination is to locate the position of the testicle and monitor changes in its position. If the testicle is in the groin, your doctor may be able locate it by touch. If it can't be felt (nonpalpable), then he or she will likely refer you to a pediatric urologist for further tests. Some undescended testicles are nonpalpable.
If your son has a nonpalpable testicle, the pediatric urologist may order one or more of the following procedures:
Other diagnostic issues
Treatments and drugs
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.
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:
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 maturity.
Lifestyle and home remedies
Even after corrective surgery, it's important to check the condition of the testicles to ensure they develop normally. You can help your son by being aware of the development of his body and talking to him about it.
Coping and support
If your son doesn't have one or both testicles, he may be sensitive about his appearance. He may have anxieties about looking different from friends or classmates, especially if he has to undress in front of others in gym class. The following strategies may help him cope:
Last Updated: 2010-10-14
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