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What is an undescended testicle?
An undescended testicle is a testicle that has not moved down into a baby boy's scrotum by birth. The condition is also known as cryptorchidism or a maldescended testicle. In some cases, both testicles fail to descend.
If your baby has an undescended testicle, his scrotum will be smaller than normal and may look uneven or asymmetrical. If both testicles do not descend, your baby's scrotum may be symmetrical, but it will look small or flat.
About 4 percent of full-term newborn boys are born with this condition, and nearly 30 percent of premature babies have one or two testicles that haven't descended by birth. It's more common in preemies because testicles begin to descend about eight weeks before birth.
During your baby's first exam after birth, his healthcare provider will check to see if both testicles have dropped into the scrotum (or into the canal just above it). If they haven't, and if they don't come down by the time your baby is 4 months old, schedule an appointment with a pediatric urologist.
In another condition called a retractile testicle, the testicles are normal, but one or both are pulled back out of the scrotum because of a muscle reflex. However, this is rare in babies and most commonly affects boys between ages 6 and 10 years old. It doesn't require treatment because the testicle will descend on its own at puberty.
What causes an undescended testicle?
No one knows for sure. It may have to do with a hormonal imbalance in the mother, or it may be an abnormal response by the baby's body to his mother's normal hormones. Sometimes a fibrous growth blocks the path of the testicle, and in some cases, the muscles involved in bringing down the testicles don't work properly.
What can be done about undescended testicles?
In most cases (about 70 percent), undescended testicles come down on their own within 6 months. But if both testicles haven't descended by this time, it's likely that your child will need surgery. This type of surgery is usually done between ages 6 months and 2 years.
If the testicle is in the groin, the surgery is done with laparoscopy: A thin, lighted tube inserted into a small incision allows the surgeon to access the testicle and move it to the scrotum. If the testicle is thought to be in the abdomen, open surgery may be needed to bring it down into the scrotum. These surgeries are done under general anesthesia and no overnight stay is required.
In about 5 percent of cases, the surgeon will not find the testicle at all. This is sometimes called a "vanished testicle." If this is the problem, the surgeon will anchor the good testicle in the scrotum to prevent it from twisting around in the extra space.
What happens if an undescended testicle is left untreated?
The longer a testicle stays inside the body, where it's warmer than in the scrotum, the lower the chances the sperm in that testicle will mature normally. If both testicles remain undescended, it can be a cause of fertility problems later in life.
Undescended testicles are also associated with a slight increased risk of testicular cancer later in life.
In very rare cases, an undescended testicle can twist and cut off its own blood supply, causing pain in the groin or scrotum. This can permanently damage the testicle. If your child has an undescended testicle and pain in this area, call his provider right away.