What is an undescended testicle?
During fetal development, the testicles descend from the abdomen into the scrotum. When a testicle does not migrate downward, it is an undescended testicle. The testicle may descend into the proper position without treatment within 3 to 4 months of life. If this does not occur, the risk of infertility increases. Warmer temperatures within the abdomen can impair the development of the testicles and the production of sperm. Undescended testicles are also slightly more prone to testicular cancer.
Why come to Children's Hospital Colorado for treatment of this condition?
The professionals at Children's Hospital Colorado in Aurora, Colorado are dedicated to caring for kids. The members of the urology team are experts in pediatric urologic conditions and our surgeons are specialized in both pediatrics and urology. We strive to help patients and families feel educated about their condition, prepared for treatment and fully cared for by our urology team.
What are the signs and symptoms?
If your child has undescended testicle(s), one or both of the testicles may appear to be missing or are not felt within the scrotum. If your child has one undescended testicle, the scrotum may look lopsided. If both testicles are undescended, the scrotum may appear to be small. If your child has retractile testicle(s), the testicle may be visible at times and appear to be missing at others.
How do you diagnose it?
Your child will undergo a genital examination to determine whether the size and development of the scrotum and testicles are normal. The health care provider may be able to feel the testes, but not see it in the scrotum and may attempt to bring the testicle downward into the scrotum. If it comes down into the scrotum, it is retractile and requires no treatment. The diagnosis of undescended testes is made if the testicle is non retractile or not found upon exam.
How is it treated?
If a testicle can be felt within the groin, your child may undergo a surgical procedure called an orchiopexy. During this procedure, a small incision is made in the groin so the testicle can be located. A second incision is then made at the base of the scrotum, where the testicle is sutured in place, to prevent it from twisting or moving upward.
In about 20% of males, the testicle cannot be felt within the groin. This can mean that a testicle is not present, or that it is within the abdomen. The presence and location of the testicle is determined by a surgical procedure called laparoscopy. If the testicle is found and is healthy, it can then be brought into the scrotum. This may require more than one step, especially if the testicle is found within the abdomen. If the testicle is not healthy, it may be necessary to remove it. These operations are usually outpatient procedures and the patient does not need to spend the night in the hospital.
Who gets it, and can it be prevented?
Undescended testes occur in about 1% to 3% of male infants, 21% of premature male infants, and 3% to 4 % of full term infants. The exact cause is unknown.
When should I seek medical attention?
Your primary care physician will perform a genital exam at birth and at each check-up. If the diagnosis is questionable, he will refer your child to a pediatric urologist.