An undescended testicle, also medically known as cryptorchidism, is a condition whereby one or both testicles fail to move into the scrotum before birth. uring normal foetal development, the testicles form inside the abdomen and gradually descend into the scrotum before birth. However, in the case of undescended testicles, one or both testicles remain in the abdomen or fail to reach the scrotum entirely.1,2 In this article we will cover the potential causes, symptoms, diagnosis and management behind cryptorchidism.
Causes of undescended testicle
esticles form while the baby is still in the womb. They form in the lower abdomen and later drop into the scrotum toward the end of the pregnancy. Babies hormones control this progress and normally the testicles attach themselves to the bottom of the scrotum. But sometimes this process gets interrupted which causes cryptorchidism.1,4
The exact cause of why this happens is not always clear, however, there are several factors that can contribute to the condition. Premature birth, hormonal imbalances, genetic factors, and maternal smoking during pregnancy are among the known reasons that could cause undescended testicles.1,4
Signs and symptoms of undescended testicle
In most cases, an undescended testicle can be detected during a routine physical examination shortly after birth. However, if for some reason the condition goes undiagnosed, it may become noticeable as the child grows older. Signs and symptoms may include an empty scrotum, small or underdeveloped scrotum, or a testicle that can be felt in the groin. There shouldn’t be any pain associated with undescended testicles, however, they can lead to long-term complications if left untreated.1,4
Management and treatment for undescended testicle
The management and treatment options for undescended testicles depend on various factors, such as the age of the individual and the location of the testicle. In most cases, the testicle may descend into the scrotum on its own during the first few months of life.1,3
However, if the testicle remains undescended after six months, it is unlikely to descend on its own. In this case, small surgery will be needed to correct it. There are two choices of surgery, if the testicle can be felt in the groin, then a surgery called orchidopexy will be performed. In this surgery the testicle will be manually moved down to the scrotum via making two small incisions.1,3
If the testicle can not be felt in the groin, then it might mean it’s either deeper in the abdomen or has not developed properly. Either way, a laparoscopic surgery will be performed to manage the situation. 1,3
Previously written articles may state that hormone treatment may be suitable for undescended testicles. However, new studies have shown that hormone treatment is not as effective.2
Diagnosis of undescended testicle
The diagnosis of undescended testicle typically involves a physical examination by a healthcare professional. Doctors will evaluate the scrotum and groin area to determine the location of the testicles. Additional tests, such as ultrasound or a laparoscopic surgery, may be recommended to confirm the diagnosis and assess the condition of the testicles. These diagnostic procedures are safe and effective, allowing healthcare providers to make informed decisions regarding treatment.1,4
While the exact cause of undescended testicles is not always known, certain factors can increase the risk of developing the condition. Premature birth, low birth weight, family history of undescended testicles are the main risk factors in most cases.
Other risk factors include smoking during pregnancy, maternal obesity, maternal diabetes, pesticides, ibuprofen, preeclampsia, and congenital malformation syndromes such as Down syndrome, Prader–Willi syndrome, and Noonan syndrome.2
If left untreated, undescended testicles can lead to potential complications later in life. These complications may include infertility, an increased risk of testicular cancer, and an increased risk of testicular torsion, which is a painful twisting of the testicle. However, with early detection and appropriate treatment, the risk of complications can be significantly reduced.1,4
Can undescended testicle be prevented
Unfortunately, there are no guaranteed methods for preventing undescended testicle. However, avoiding the controllable risk factors, such as maternal smoking during pregnancy, can greatly reduce the chances of developing the condition.
How common is undescended testicle
Undescended testicle is a relatively common condition, affecting approximately 3-5% (or about 1 in every 25) of full-term male infants. The prevalence is even higher in premature infants, with up to 30% being affected. In 1% of the cryptorchidism cases, the tested will remain undescended if left untreated.1,4
When should I see a doctor
In normal circumstances, undescended testicle should be noticed during regular check-ups of the baby. tHowever, if you suspect that you or your child may have an undescended testicle, it is important to consult a healthcare professional or get in touch with your GP. They can perform a thorough physical examination and provide appropriate guidance and treatment options.
Undescended testicle, or cryptorchidism, occurs when one or both testicles fail to descend into the scrotum before birth. The causes of this condition are not always clear, but factors such as premature birth, hormonal imbalances, genetic factors, and maternal smoking during pregnancy can contribute to it.
While undescended testicles can often be detected during a routine physical examination after birth, if left undiagnosed, they may become noticeable as the child grows older. Treatment options depend on the age and location of the testicle, and may include surgery. Diagnostic procedures such as physical examination, ultrasound, or laparoscopic surgery can help confirm the diagnosis. Risk factors for undescended testicles include premature birth, low birth weight, family history, and various maternal factors.
If left untreated, undescended testicles can lead to complications such as infertility, an increased risk of testicular cancer, and testicular torsion. While there are no guaranteed methods for prevention, avoiding controllable risk factors such as maternal smoking during pregnancy can reduce the chances of developing the condition.
Undescended testicles are relatively common, affecting approximately 3-5% of full-term male infants and up to 30% of premature infants.
- NHS UK https://www.nhs.uk/conditions/undescended-testicles/
- Leslie SW, Sajjad H, Villanueva CA. Cryptorchidism. [Updated 2023 Mar 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470270/
- Urology Care Foundation https://www.urologyhealth.org/urology-a-z/u/undescended-testicles-(cryptorchidism)
- Royal Childrens Hospital Melbourne https://www.rch.org.au/kidsinfo/fact_sheets/Undescended_testes/