Some infants are born with testes that have not descended into the scrotum. Instead, one or both remain in the abdominal cavity, the groin or the upper scrotum. This condition is known as undescended testicles or cryptorchidism and is treatable by expert pediatric urologists at Riley at IU Health.
Undescended testes are more common in premature infants (up to 30 percent) than in full-term babies (only 3 percent). Fortunately, only a small percentage of boys (approximately 1 percent) require treatment because the testicles often descend as babies grow and develop.
This condition is usually diagnosed during the first year of life by a parent or pediatrician. Boys are sometimes diagnosed with undescended testes later in childhood or in adolescence.
Diagnosis of Undescended Testes
The first step in diagnosis for undescended testes is repeated testicular examination. Other diagnostic tools are laparoscopy and, in rare cases, imaging such as ultrasound. The condition falls on a spectrum, from the least to the most serious:
- Retractile testes are a natural reflex of the testicles to occasionally move where they cannot be seen nor felt on repeat physical exams.
- Ascended testes are a progressive upward movement of the testicles during and throughout childhood. Testicles can be felt on exam, but keep moving up with each subsequent exam.
- Undescended, palpable testes means the testicle cannot be seen, but it can be felt during physical exams.
- Undescended, non-palpable testes occur when the testicles cannot be seen or felt on physical exam.
Treatments
Treatments
Our highly skilled physicians are trained to diagnose and treat your child’s undescended testicles wherever he falls on the spectrum. A visit with one of our pediatric urologists begins by collecting a history and finishes with a physical exam. Sometimes our experts can feel testicles that cannot be felt or seen by you or your child’s physician.
Occasionally, a surgery known as an orchiopexy may be necessary to find the undescended testicle and correct the problem, depending on where the testicle is located. The surgery may be performed through a small incision on the scrotum, on the groin or both. In rare cases, some children need more than one procedure due to complicated anatomies that must be corrected in stages.
Laparoscopic surgery is sometimes needed. Urologists insert tiny instruments and a camera through small incisions to find the testicle and correct the problem. In most cases, we use an open incision in the groin, scrotum or both. Sometimes the approach cannot be determined until we are in the operating room.
Undescended testes should not be left untreated, and early treatment is recommended. Surgical correction preserves how testicles produce sperm. Treatment also reduces the risk of testicular cancer, which is slightly higher in boys with undescended testes.
Key Points to Remember
Key Points to Remember
- Undescended testes stay in the abdomen, groin or upper scrotum instead of dropping into the lower part of the scrotum where they belong.
- Only a small percentage of children need treatment for undescended testes.
- Undescended testes are usually diagnosed during the first year of life, but occasionally this condition is not detected until the age of 10 or even in adolescence.
- Retractile testes are a natural reflex in some boys up to a certain age, and may not need treatment.
- If treatment is needed, it can be as simple as laparoscopic surgery or an open surgery to move the testicle into the scrotum.
- Undescended testes have no symptoms, but treatment is important because it can improve spermatic function and reduce testicular cancer risk.
Support Services & Resources
Support Services & Resources
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This website publishes research, summaries, reviews and reports for consumers, policymakers and healthcare providers, including a summary about treatment for undescended testicle.
This organization supports pediatricians and offers information for parents about undescended testicle through its website, HealthyChildren.org.
This organization provides education and support to family physicians. Their online publication, American Family Physician, includes articles about health conditions such as undescended testicle.
This National Institutes of Health website offers information and links about health conditions, including undescended testicle(s).
Locations
Locations
Locations
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.