What Is Retractile Testicle

A retractile testicle is characterised by its ability to move back and forth between the scrotum and the groin. During a physical examination, if the testicle is found in the groin, it can be easily guided by hand into its proper position in the scrotum—the pouch of skin located behind the penis. Once released, the testicle typically remains in the correct position, at least temporarily.

In most cases, this issue resolves naturally for boys before or during puberty. The testicle eventually moves to its appropriate location in the scrotum and remains there permanently.

However, in some instances, the retractile testicle may persist in the groin and become immovable. When this occurs, the condition is referred to as an ascending testicle or an acquired undescended testicle.

Symptoms & causes

A retractile testicle is often associated with the cremaster muscle, a thin pouch-like muscle in which the testicle rests. The cremaster muscle has a reflex known as the cremasteric reflex, where it contracts (tightens) and pulls the testicle upward toward the body. This reflex can be triggered by various factors such as cold, touch, and anxiety. In some boys, an exaggerated cremasteric reflex can lead to a retractile testicle.

Signs and symptoms of a retractile testicle include the occasional absence of one or both testicles. These testicles can be easily moved by hand down to the scrotum without causing pain and typically stay in the scrotum when the cremaster muscle is fatigued.

Diagnosis & tests

If the testicle is not in the scrotum, the doctor will determine its location in the groin. During the examination, the doctor will attempt to gently guide it into its proper position in the scrotum. This examination may take place while lying down, sitting, or standing. For toddlers, specific positions, such as sitting with the soles of their feet touching and knees to the sides, may be used to facilitate the identification and manipulation of the testicle.

If the testicle is retractile, it will move relatively easily and won't immediately return to the groin.If the testicle in the groin quickly retreats to its original location, it is more likely an undescended testicle.

Management & treatment 

Retractile testicles generally do not require surgery or other treatment. They are likely to descend on their own before or during puberty. If your son has a retractile testicle, the doctor will monitor any changes in its position during annual evaluations to determine if it remains in the scrotum, continues to be retractile, or develops into an ascending testicle.

FAQ

Complications

Retractile testicles are generally not associated with complications, aside from a greater risk of the testicle becoming an ascending testicle.

Coping and support

Supporting your son with a retractile testicle involves understanding and addressing potential sensitivity about his appearance. Here are some suggestions to help him cope:

1. Explain in simple terms: Provide a straightforward explanation of what a retractile testicle is, using language appropriate for his age and understanding
2. Reassure him: Remind your son that there is nothing wrong with him. Emphasise that this is a common and manageable condition.
3. Discuss monitoring and potential intervention: Explain that you, your son, and his doctor will keep an eye on the position of the testicle and, if necessary, take steps to address it. Reinforce the idea that medical professionals are there to help.
4. Practice responses: Work with your son to develop responses if he ever feels teased or is asked about the condition. Encourage him to confidently share basic information about retractile testicles to help dispel any misconceptions

By providing information and emotional support, you can help your son navigate any concerns or questions related to his retractile testicle.

Preparing for your appointment

Diagnosing a retractile testicle is typically within the scope of your son's regular doctor. However, if there are uncertainties about the diagnosis or a need for immediate treatment, a referral to a pediatric urologist, a specialist in urinary disorders and male genital issues in children, may be suggested.

To assist in the diagnosis, be prepared to answer or help your son answer the following questions:

1. Were both testicles previously identified as descended in a well-baby or annual exam?
2. When did you notice the absence of the testicle in the scrotum?
3. Have you observed this before?
4. Has your child experienced any pain in his testicles or groin?
5. Has your son ever been treated for a hernia?
6. Has your son experienced any trauma to his genitals or groin?

Providing accurate and detailed information will aid the healthcare provider in making an informed diagnosis and determining the appropriate course of action.

Summary

A retractile testicle is characterised by its movement between the groin and the scrotum, which is the sac underneath the penis. It is generally not considered a serious health risk. This condition can impact young boys, and the majority tend to outgrow a retractile testicle by the time they reach puberty.²