As a baby boy
grows inside his mother, he develops
testicles. Early in his development, his testicles are
in his belly. Normally, before he is born, his testicles move down into his
scrotum, the sac that hangs below the penis. When one
testicle does not move into the scrotum as it should, the baby has an
undescended testicle. In rare cases, both testicles
It is most common in baby boys who
were born before their due date or who were very small at birth.
Doctors don't really know what causes an undescended testicle. This common condition runs in some families (can be
Most of the time, the testicle descends (drops) on
its own by the time the baby is 3 months old. If your baby's testicle hasn't dropped by the time he is 6 months of age, your doctor may suggest
testicle doesn't cause pain or other symptoms. The scrotum may look a little
smoother or less developed on one side, or the side without a testicle may look
smaller and flatter. You can't feel the testicle in the scrotum on the side where it hasn't descended.
newborn and well-baby visits, your doctor will check your baby's scrotum.
Some other conditions are closely related to undescended testicles, such as an ectopic or retractile testicle. In both of these conditions, the testicle is in an abnormal position in the groin or scrotum. Your
doctor will take care to make the correct diagnosis so your child can get the
Usually doctors recommend a
wait-and-see approach for newborns. If the testicle
hasn't dropped on its own within 6 months, your doctor may
recommend surgery (orchiopexy or orchidopexy). Surgery is done when the baby is 9 to
15 months old. It is safe and effective and has few risks. Most babies recover quickly.
When babies have a testicle that can't be felt, doctors may do a different surgery that needs only a small
Another treatment is hormone therapy. It may cause the testicle to drop down into the scrotum. If it works, surgery isn't needed. But it doesn't always work, and it may cause side effects.
Treatment is important, because having an undescended testicle increases
the risk of:
Learning about undescended testicles:
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Other Works ConsultedBarthold JS (2012). Abnormalities of the testis and scrotum and their surgical management. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 4, pp. 3557–3596. Philadelphia: Saunders.Pettersson A, et al. (2007). Age at surgery for undescended testis and risk of testicular cancer. New England Journal of Medicine, 356(18): 1835–1841.Walsh TJ, et al. (2007). Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. Journal of Urology, 178(4, Part 1): 1440–1446.Zeitler PS, et al. (2012). Endocrine disorders. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 21st ed., pp. 1011–1052. New York: McGraw-Hill.
December 28, 2012
John Pope, MD - Pediatrics & Peter Anderson, MD, FRCS(C) - Pediatric Urology
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