Retractile Testicle(s)

What are retractile testicles?

Retractile testicles are testicles that are connected to more active muscles that cause the testicle to move in and out of the base of the scrotum regularly. This is a normal finding. Retractile testicles are commonly described as testicle that do not always rest down in his scrotum, but will often be seen there when he is in the bath or asleep. A retractile testicle is sometimes seen outside the scrotum due to an active cremasteric reflex. The cremasteric reflex is elicited by lightly stroking the inner part of the thigh. The cremaster muscle contracts in the body which is responsible for pulling the scrotum and testes up on the side that is stroked (like a yo-yo). Retractile testes function normally. They are palpable and not considered to be a true undescended testicle. 90% of retractile testicles will descend and relax into the scrotum during puberty. Until that time, regular testicular exams are important to monitor for abnormalities.

What is involved in a testicular exam?

It is important for the child to do self-examinations of his testicles. (A caregiver can do the examinations until the child is old enough to do it himself.) These examinations involve the testicle be palpated by hand; it is not invasive. If at any point the child, his caregiver or his primary care doctor cannot bring his testicle into his scrotum, please contact the CHOC Urology Center and make an appointment to see one of our specialists.

It is also important when the boy is around 10 years old to teach him how to do testicular self-exams to feel for any abnormalities. They should be relatively the same size on each side and feel like smooth marbles. Be sure his primary care provider or other medical professional teaches him proper technique for monthly self examinations when he is of appropriate age.

What is the best way to feel for a testicle in the scrotum?

• Do place one hand on the pelvis/abdominal area and ‘milk’ your hand down to keep the testicle moving downwards towards the scrotum.
• Our staff will demonstrate how to do this in our office
• Do not just feel from the bottom to see if the testicle is present, this will induce the cremasteric reflex and make it difficult for you to find the testicle.
• Do examine for the testicles in the scrotum while your child is asleep or relaxing in the bath, often the testicles will be found in the scrotum during these times very easily.
• Do have your son squat into a “baseball catcher’s position” to exam him, this relaxes the cremaster muscle and allows the testicles to relax into the scrotum well.

At every well-child visit, the child’s health provider should be able to bring his testicles into the scrotum. Between these yearly visits you or your child can examine the testicles for their occasional presence in the scrotum. If at any time they are not palpable or able to be brought into the base of the scrotum, or if you or your child have further concerns please contact the CHOC Urology Center for follow-up.