A retractile testicle is a testicle that may move back and forth between the scrotum and the groin. When the retractile testicle is residing in the groin, it may be easily guided by hand into its proper position in the scrotum — the bag of skin hanging behind the penis — during a physical examination.
For most boys, the problem of a retractile testicle goes away sometime before or during puberty because this is usually when the testicle permanently moves to its correct location in the scrotum.
Sometimes, the retractile testicle is no longer movable and instead stays up in the groin. When this happens, the testicle is no longer considered a retractile testicle. This condition is called an ascending testicle.
Testicles form in the abdomen during fetal development. During the final months of development, the testicles gradually descend into the scrotum. If your son has a retractile testicle, the testicle originally descended as it should, but then it didn't remain in place.
Signs and symptoms of a retractile testicle include the following:
The movement of the testicle almost always occurs without pain or discomfort. Therefore, a retractile testicle is noticed only when it is no longer seen or felt in the scrotum.
The position of one testicle is usually independent of the position of the other one. For example, a boy may have one normal testicle and one retractile testicle.
Retractile testicle is different from undescended testicle (cryptorchidism). The undescended testicle is one that never entered the scrotum. If a doctor attempted to guide an undescended testicle, it wouldn't move or would move slightly, most likely with some discomfort or pain.
When to see a doctor
If your son experiences pain in the groin or testicles, see your son's doctor immediately.
An overactive muscle causes a testicle to become a retractile testicle. The cremaster muscle is a thin pouch-like muscle in which a testicle rests. When the cremaster muscle contracts, it pulls the testicle up toward the body.
The primary purpose of the muscle is to control the temperature of the testicle. In order for a testicle to develop and function properly, it needs to be slightly cooler than normal body temperature. When the environment is warm, the cremaster muscle is relaxed; when the environment is cold, the muscle contracts and draws the testicle toward the warmth of the body.
During childhood, the cremaster muscle may be particularly overactive. If this reflex is strong enough, it can result in a retractile testicle, pulling the testicle out of the scrotum and up into the groin.
Causes of an ascending testicle
The ascending testicle occurs because some part of the anatomy is pulling up on the testicle. Contributing factors may be:
A boy with a retractile testicle may be vulnerable to these complications:
Preparing for your appointment
Your son's pediatrician can usually diagnose a retractile testicle. However, if he or she believes your son needs treatment, you may then be referred to a doctor who specializes in urinary disorders and problems with male genitals in children (pediatric urologist).
Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to arrive well prepared. Here's some information to help you get ready for the appointment, and what to expect from your child's doctor.
What you can do
Preparing a list of questions can help you make sure that you cover the points that are important to you. List your questions from most important to least important in case time runs out. For retractile testicle, some basic questions to ask your child's doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Tests and diagnosis
If your son has a testicle not located in the scrotum, his doctor will determine its location in the groin. Once it's located, the doctor will attempt to guide it gently into its proper position in the scrotum.
Your son may be lying down, sitting or standing during this examination. If your son is a toddler, the doctor may have him sit with the soles of his feet touching and knees to the side. Older boys may be asked to squat. These positions often make it easier to find and manipulate the testicle. In addition, it's important that this exam is done in a warm location and that the doctor has warm hands, because cold can stimulate the cremaster reflex.
If the testicle is a retractile testicle, it will move relatively easily and painlessly. The retractile testicle won't immediately move up again. Your son's doctor can then stimulate the reflex of the cremaster muscle by gently rubbing the upper inside of the thigh. This stimulation will usually cause the retractile testicle to move up again.
If the testicle in the groin moves only part way into the scrotum, if the movement causes pain or discomfort, or if the testicle immediately retreats to its original location, it's most likely not a retractile testicle. In such cases the testicle would be considered undescended or ascending if the testicle had been in the scrotum at one time.
Treatments and drugs
A retractile testicle is likely to descend on its own before or during puberty. If your son has a retractile testicle, your son's doctor will monitor any changes in the testicle's position in annual evaluations to determine if it stays in the scrotum, remains retractile or has become an ascending testicle.
If the testicle has ascended — no longer movable by hand — or if it's still retractile by age 14, your son's doctor may recommend treatment. The goal of treatment is to have the testicle permanently descend, which may lessen the risk of complications. Treatments include:
It is important to understand that even with successful treatment of an ascending or retractile testicle, the increased risk of testicular cancer remains. However, surgical treatment before puberty can lessen the risk of testicular cancer, and the overall risk of testicular cancer is quite low.
Adolescent boys and men who have had treatments to correct an ascending or retractile testicle should regularly monitor the position of the testicle to ensure it doesn't ascend at a later time.
Lifestyle and home remedies
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 has a retractile testicle, 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: 2010-06-15
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