As a baby boy grows inside his mother's womb, his testicles typically form inside his abdomen and move down (descend) into the scrotum shortly before birth. But in some cases, that move or descent doesn't occur, and the baby is born with a condition known as undescended testicles (or cryptorchidism).
Cryptorchidism is the most common genital abnormality in boys, affecting approximately 30% of baby boys born prematurely and about 4% born at term.
In about half of the babies, the undescended testicles move down or descend on their own by the sixth month of life. If descent doesn't happen by then, it's important to get treatment because testicles that remain undescended may be damaged, which could affect fertility later or lead to other medical problems.
Doctors usually diagnose cryptorchidism during a physical exam at birth or at a checkup shortly after. In 7 of 10 boys with an undescended testicle (or "testis"), it can be located or "palpated" on examination by the pediatric specialist.
In 3 of 10 boys, the testicle may not be in a location where it can be located or palpated, and may appear to be missing. In some of these cases, the testicle could be inside the abdomen. In some boys with a "non-palpable" testicle, however, the testicle may not be present because it was lost while the baby was inside the womb.
In some boys, the testicles (or "testes") may appear to be outside of the scrotum from time to time, which can raise the concern of an undescended testicle. Some of these boys may have the condition known as retractile testes. This is a normal condition in which the testes reside in the scrotum but on occasion temporarily retract or pull back up into the groin.
There is no need to treat a retractile testicle, since it is a normal condition, but it might require examination by a pediatric specialist to distinguish it from an undescended testicle.
If a baby's testicle has not descended on its own within the first 6 months of life, the boy should undergo evaluation by a pediatric specialist and treatment if the condition is confirmed. This usually involves surgically repositioning the testicle into the scrotum.
Treatment is necessary for several reasons:
If surgery is done, it's likely to be an orchiopexy, in which a small cut is made in the groin and the testicle is brought down into the scrotum where it is fixed (or pexed) in place. Doctors typically do this on an outpatient basis, and most boys recover fully within a week.
Most doctors believe that boys who've had a single undescended testicle will have normal fertility potential and testicular function as adults, while those who've had two undescended testicles might be more likely to have diminished fertility as adults.
It is recommended that all boys who've had undescended testicles undergo follow-up evaluations by a urologist for years after their corrective surgeries.
It is important for all boys — even those whose testicles have properly descended — to learn how to do a testicular self-exam when they are teenagers so that they can detect any lumps or bumps that might be early signs of medical problems.
Reviewed by: T. Ernesto Figueroa, MD
Date reviewed: May 2014
|American Academy of Pediatrics (AAP) The AAP is committed to the health and well-being of infants, adolescents, and young adults. The website offers news articles and tips on health for families.|
|Is It Normal for One Testicle to Be Bigger? Find out what the experts have to say.|
|Why Does the Doctor Have to Examine My Testicles? Find out what the experts have to say.|
|Hernias Hernias are fairly common in kids and hernia repair is the one of the most common surgeries performed on children.|
|For Boys: Trouble "Down There" Boys might feel embarrassed if they get hurt or have a health problem "down there." Find out more in this article for kids.|
|A Primer on Preemies Premature infants, known as preemies, come into the world earlier than full-term infants and have many special needs that make their care different from that of other babies.|
|Ultrasound: Scrotum Doctors order a scrotal ultrasound when they're concerned about symptoms such as scrotal pain or swelling.|
|Why Do Doctors Perform Testicular Exams? Find out what the experts have to say.|
|Testicular Injuries Serious testicular injuries are relatively uncommon, but testicular injury can be painful. Read this to find out what steps you can take to protect yourself from injury.|
|Testicular Exams If you're a guy, you may be wondering why the doctor needs to do a testicular exam. Find out in this article.|
|How to Perform a Testicular Self-Examination The testicular self-examination (TSE) is an easy way for guys to check their own testicles to make sure there aren't any unusual lumps or bumps - which are usually the first sign of testicular cancer.|
|When Your Baby Is Born With a Health Problem If you're expecting a baby, it's important to understand that certain health problems and complications can't be prevented, no matter how smoothly the pregnancy goes.|
|Varicocele A varicocele is an enlargement of the veins in the scrotum. Although there is no way to prevent a varicocele, it usually needs no special treatment.|
|Male Reproductive System Understanding the male reproductive system, what it does, and problems that can affect it can help you better understand your son's reproductive health.|
|Male Reproductive System What makes up a guy's reproductive system and how does it develop? Can anything go wrong? Find the answers to these questions and more in this article.|
What to expect when coming to Akron Children's
For healthcare providers and nurses
Residency & Fellowships, Medical Students, Nursing and Allied Health
For prospective employees and career-seekers
Our online community that provides inspirational stories and helpful information.