Undescended Testicle (Cryptorchidism)

Undescended testicle at a glance

  • An undescended testicle is one that hasn’t moved down into the correct position in the scrotum before the child is born.
  • Approximately 3-4 percent of male infants are born with an undescended testicle, a condition also known as cryptorchidism, which means hidden or obscure testicle.
  • Undescended testicles are common in premature babies.
  • About 50 percent of undescended testicles resolve on their own within the first months of the boy’s life.
  • Left untreated, undescended testicles may cause health issues as the boy ages, such as infertility and a slightly increased chance of testicular cancer.

What is an undescended testicle?

The testicles of a male fetus generally descend into the scrotum before birth, but if this does not occur, the boy will have an undescended testicle.

Testicles develop fairly early during pregnancy, usually around 6-8 weeks of pregnancy. Testicles are formed in the abdominal cavity and typically descend to the scrotum at about week 28.

About 3-4 percent of all male infants are born with an undescended testicle, and approximately 21 percent of all prematurely born males will be diagnosed with an undescended testicle. Roughly half of all cases of undescended testicles will resolve without any treatment by three months of age.

After three months of age, testicles will not descend on their own and medical treatment is necessary to fix the issue.

What causes undescended testicles?

At this time there is no concrete evidence as to what causes undescended testicles. Genetics, environmental factors and maternal health may all contribute.

Some children may have abnormally developed testicles and others may have a structural problem that does not allow their testicles to drop. Additionally, some children’s testosterone levels may not be high enough to stimulate the testicles to descend to the scrotum.

What are the signs & symptoms of undescended testicles?

The primary sign of an undescended testicle is the absence of a testicle where one would expect to see or feel a testicle. Doctors discover most undescended testicles right after the child’s birth.

Undescended testicles do not cause any pain to the child. However, it is important to consult a physician if a child is believed to have this problem, as undescended testicles can cause health problems.

What are the risks of an undescended testicle?

If left untreated, complications from an undescended testicle include infertility, hernia and a higher risk for testicular cancer later in the child’s life.

Risk of testicular cancer

Even if the testicle is brought into the scrotum through surgery, the undescended testicle is more likely to develop cancer, as is the other normal testicle. As the male reaches puberty and beyond, he should perform regular testicular exams to look for testicular cancer or growths.

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Risk of infertility

The purpose of the scrotum is to keep testicles at a lower temperature than the rest of the body, because higher body temperatures reduce the output and quality of sperm. Throughout a boy’s childhood, his sperm goes through a maturation process and are fully developed by puberty.

If the testicles are undescended, meaning not in the scrotum, the sperm are unable to mature due to exposure to higher internal temperature. The longer a testicle remains undescended, the lower the chance of the child producing mature sperm upon reaching puberty.

What is the treatment for an undescended testicle?

Aside from the testicle descending on its own, surgery is the primary treatment for undescended testicles. A physical examination by a doctor will first determine if the testicle is undescended or is simply retractile, the reflex that causes a male’s testicles to rise into the abdominal cavity when he is cold or frightened.

Undescended testicles that cannot be felt during a physical examination are called non-palpable. A non-palpable testicle may be too far into the abdomen to feel, too small to feel, or may not have developed at all. In this case, imaging tests may be used to locate the testicle. Surgery may also be required to locate or determine the absence of the testicle.

Surgery performed by a urologist may still be required to fix the problem. The urologist will create a small incision in the groin area and lower the testicle to the scrotum. The urologist will then stitch the testicle into place in the scrotum. The child is typically allowed to return home the day of surgery.

Most males who have surgery to fix an undescended testicle will develop normally and will have a normal probability of fathering a child.

To learn more about undescended testicles, contact us to schedule an appointment with one of our board certified urologists.