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An undescended testicle is a testicle that never completely descended into the scrotum by birth. During fetal development, the testicles form inside the fetus’s abdomen and then should descend into the scrotum during the third trimester. The rate of undescended testicles is 1-3% in full term boys, and 15-30% in premature males1.
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This condition should be differentiated from a retractile testicle, which is when the testicle goes up and down between the groin to the scrotum. Retractile testicles are normal and do not require surgery, whereas an undescended testicle, where the testicle is always elevated, does require surgery.
There are typically no symptoms other than the testicle not completely descending into the scrotum.
It is not known exactly why testicles do not descend into the scrotum during fetal development, but there are genetic, hormonal, environmental and anatomical reasons that can all affect fetal testicle descent.
An undescended testicle is diagnosed with a physical exam. The urologist will check if they can feel both testicles in the scrotum or groin. Imaging such as ultrasound, x-ray, or MRI is not helpful in diagnosing undescended testicles, even if a testicle is not palpable.
While most testicles can spontaneously descend on their own in the first few months of life. If the testicles are not in the scrotum by 6 months, your baby will need a surgery called an orchiopexy. It can be performed through a small incision in the groin and the scrotum; if the testicle is not palpable, it can be done laparoscopically with small incisions in the abdomen. Surgery should be done between 6-18 months under general anesthesia, typically taking less than 1 hour.
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