What Are Undescended Testicles?
Undescended testicles can lead to problems with fertility, make cancer more likely, and increase the odds of injury. Learn more about the condition.
In your third trimester of pregnancy, your baby goes through all sorts of changes. His bones fully form, his eyes open, and he fleshes up and gains weight. It’s also when his testicles move from his lower belly to the scrotum. The scrotum is the pouch of skin just under the penis. Sometimes though, one or both testicles don’t fall into place. It can happen to any baby boy, but it’s more common for those born earlier than expected. That’s called an undescended testicle, or undescended testicles. More often than not, the testicle drops into the scrotum on its own by the time the baby is 6 months old. If it doesn’t, the child will likely need surgery.
What Causes Undescended Testicles?
Doctors cannot say for sure. They think it might be genetically related, or a result of the mother’s health. Some doctors also blame external influences that change how hormones and nerves normally work.
Even though the cause is unclear, there are certain factors that increase the likelihood of undescended testicles:
- A pre-term birth
- Family history of undescended testicles or other problems with how genitals develop
- Health conditions, such as Down syndrome, that affect the growth of a foetus
- Low birth weight
- Contact by the parents with certain chemicals (pesticides) that kill bugs. These are often used on farms.
It may also be more likely if the mother:
- Has diabetes (type 1, type 2, or gestational)
- Is obese
- Smoked cigarettes or drank alcohol during pregnancy
How Do I Know There’s a Problem?
The main sign: You can’t see or feel the testicle in the scrotum. When both are undescended, the scrotum looks flat and smaller than you’d expect it to be.
Some boys have what’s called a retractile testicle. It may move up into his groin when he is cold or scared but moves back down on its own. It’s generally not a problem. The difference is that an undescended testicle stays up — it doesn’t move back and forth.
How Is It Diagnosed?
Your doctor will probably diagnose undescended testicles during a physical exam at birth or at a checkup shortly after. Most times, the doctor can locate a testicle on exam. In a few boys, the testicle may not be easily located or palpated, and may appear to be missing. In some of these cases, the testicle could be inside the abdomen.
Some boys may have retractile testes. This is a normal condition in which the testicles can appear to be outside of the scrotum from time to time. It raises the concern of an undescended testicle. The testes usually are in the scrotum, but sometimes temporarily pull back up into the groin. A retractile testicle doesn’t require treatment because it’s a normal condition. But a pediatric specialist might need to do an exam to distinguish it from an undescended testicle.
What Problems Can It Cause?
An undescended testicle is related to a number of conditions:
Fertility problems. Because sperm need to be a little cooler than the rest of the body, an undescended testicle can cause fertility issues. This is more of a problem when both are lodged in the groin. Early treatment can make a big difference.
Hernia. This is a condition where part of the intestine bulges through the muscles of the lower belly.
Injury. When the testicle is out of place, it’s more likely to be damaged.
Cancer. Men who have an undescended testicle are a little more likely to get testicular cancer, even if they have surgery to treat it. But surgery makes routine self-exams possible, so if cancer does appear, it can be found early.
Testicular torsion. This is when the cord that carries semen to the penis gets twisted up. It’s painful and can cut off blood flow to the testicle.
Very often, the testicle moves into place within a few months. At first, you’ll want to wait and see how things go with regular check-ups. If it doesn’t drop into the scrotum by 6 months, your doctor will likely suggest surgery.
Surgery is the most common treatment, and it almost always works. It’s usually done when the baby is 6-12 months old to get the most benefit. Early treatment can lower the chances that your boy will have problems with fertility later in life.
An undescended testicle can also be treated with hormones. This isn’t the typical treatment though. It usually doesn’t work as well as surgery, and there may be side effects.