Children's Hospital Colorado

Undescended Testicles in Children

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.

What causes undescended testicle?

The exact cause of this condition is unknown.

Who gets undescended testicle?

Undescended testes occur in about 1% to 3% of male infants, 21% of premature male infants, and 3% to 4% of full-term infants.

What are the signs and symptoms of an undescended testicle?

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 a retractile testicle(s), the testicle may be visible at times and appear to be missing at other times.

What tests are used to diagnose an undescended testicle?

Your child will undergo a genital examination to determine whether the size and development of the scrotum and testicles are normal. The healthcare 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.

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.

How do doctors at Children's Hospital Colorado make a diagnosis?

A complete medical history and physical exam will help make the diagnosis for an undescended testicle. Further investigations are rarely necessary.

How is an undescended testicle 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 placed, 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, where a camera is placed into the abdomen to look for the testicle.

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, so the child does not need to spend the night in the hospital.

Learn more about the minimally-invasive surgical options in the Department of Pediatric Urology at Children's Colorado. 

Why choose Children's Colorado for your child's undescended testicle?

Our urologic surgeons have extensive experience in diagnosis and treatment of undescended testicles and understand that this can be a very sensitive topic for parents and families. We work with the family to ensure that the best course is taken for every child. We also believe that it is essential to constantly assess our outcomes, and ensure that our results are always available to families.

Learn more about the Department of Pediatric Urology at Children's Colorado.

Related departments