Undescended Testicle
See also: Cryptorchidism
What is it?
An undescended testicle is a testicle that fails to
properly move into its normal position in the scrotum. During development, in the womb,
the testicles start out positioned just below the kidneys at the back of the abdomen. As
development progresses, the testicles descend completely into the scrotum. Descent is
usually complete at birth. If a testicle fails to make it all the way to the scrotum by
birth, it is called an undescended testicle. An undescended testicle can vary in its
position. It may be just above the scrotum, or still be in the abdomen.
Undescended testicles are significant for three reasons.
The first is the issue of fertility. Proper production of sperm cells requires that the
testis reside in the scrotum, where the temperature is more suited to the production of
sperm cells. Second, undescended testicles appear to be at a slightly increases risk of
developing a malignancy (cancer) later in life. Researchers disagree whether or not proper
positioning of an undescended testicle lowers this cancer risk; however, proper
positioning of the testicle allows adequate examinations to be performed to detect
potential problems. Third, it is important for every child to appear as "normal"
as possible.
Diagnosis and Treatment
The diagnosis of an undescended testicle is made by
examining the child. Important historical information regarding this condition is whether
there has ever been evidence of a testicle in the scrotum, and whether there has ever been
any sign of a hernia. Physical exam will usually reveal the testicle to be present
somewhere in the groin, although occasionally no testicle will be detected. The scrotum is
often somewhat underdeveloped on the affected side.
Many undescended testicles will descend
fully into the scrotum during the first six months of life; therefore surgery is usually
deferred until age six months to one year of age unless complications such as a
concomitant inguinal hernia are present. The surgical correction involves identifying the
testicle in the groin by means of a small incision. The testicle, blood vessels and sperm
duct (vas deferens) are freed from their surrounding attachments. The testicle is then
anchored into the scrotum. In the case of a very high-riding testicle, a two-stage
procedure may be needed. For testicles that are not able to felt pre-operatively, the
surgeon may recommend beginning the operation with a diagnostic laparoscopy to determine
if the testicle resides in the abdominal cavity or if it has failed to develop. Physicians
in the Division of Pediatric Surgery at Penn State Children’s Hospital treat
patients with undescended testicles. We have a team of surgeons, anesthesiologists, nurses
and child life specialists dedicated to providing both you and your child with the best
operative experience possible. We believe it is important to reduce pre-operative anxiety
and to control post-operative pain and discomfort.
Glossary of Terms
Testicle/Testis: the male gonad; this structure
gives rise to sperm cells, as well as hormones necessary to the proper development of male
sexual characteristics
Orchiopexy: the operation by which the undescended
testicle is situated in the scrotum
Hernia: the defect in the abdominal wall caused by a
persistent communication between scrotum and abdominal cavity; there is often a hernia
present when the testicle is undescended.
Cryptorchid: "hidden" testicle; another term for
an undescended testicle.
Physicians who treat Undescended Testicle
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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