Undescended Testes (Cryptorchidism)

Undescended testes are a condition seen most commonly in newborns when one or both of the male testes have not passed down into the scrotal sac. Ten percent of cases are bilateral (involve both testes). Cryptorchidism is more commonly seen in premature males because the testes do not descend from the abdomen to the scrotal sac until the seventh month of fetal development.

What causes undescended testes?

Undescended testes may occur for several reasons. While prematurity is a leading cause, other causes may include hormonal disorders, retractile testes (a muscle reflex that causes a testicle to move back and forth from the scrotum to the groin), testicular absence or the cause may be unknown. Undescended testes can be unilateral (involving only one testicle) or bilateral (involving one testicle).

Who is affected by undescended testes?

• Undescended testes occur in approximately 3 to 5 percent of male infants.
• Up to one-third of premature male infants have an undescended testis.
• Undescended testes occur in 3 to 4 percent of full-term infants.
• Males whose fathers had undescended testes have a higher rate of undescended testes themselves.

What are the symptoms of undescended testes?

The most common symptom of undescended testes is the inability to feel the testis during a physical exam. However, each child may experience symptoms differently. Symptoms of cryptorchidism may resemble other conditions or medical problems.

How are undescended testes diagnosed?

Diagnosis of undescended testes is made based on a complete medical history and physical examination by a specialist.

What is the treatment for undescended testes?

75% of undescended testes resolve by 3 months of age. Resolution occurs as the testicles (or testes) descend from the small internal passageway that runs along the abdomen near the groin into the scrotal sac.

Specific treatment for undescended testes will be determined by your child’s doctor based on:

• Your child’s age, overall health and medical history.
• The extent of the condition.
• Your child’s tolerance for specific medications, procedures or therapies.
• Expectations for the course of the condition.
• The family’s opinion or preference.

Treatment does not always involve surgery. Some children may be examined periodically for a length of time to allow the testes to naturally descend. Other children may require a surgery to bring the testes down into the scrotum. This surgery is called an orchiopexy. The surgery, if needed, is usually performed between the age of 6 months and 1 year and is successful in over 98% of children with this condition.

If undescended testes are not repaired, the following complications may occur as the child grows and matures:

• Infertility, especially if both testes are affected.
• Increased risk of testicular cancer.
• Psychological consequences of an empty scrotum