What is undescended testicle?

Testicles are male sex organs that make and store sperm. Before a boy is born, his testicles normally drop into the scrotum. The scrotum is the sac that hangs below the penis. When a testicle doesn't drop before birth, it's called an undescended testicle. This means it is still in the belly. Doctors don't understand why some testicles do not descend.

Your doctor will check your child's scrotum at each visit. He or she will likely advise a wait-and-see approach at first. In most children, a testicle that hasn't dropped will move into the scrotum by the age of 3 months. In some cases, surgery is needed to move the testicle into place.

Treatment is important. This condition makes it more likely that your son may not be able to father a child later in life. It also increases the chance of having cancer of the testicles.

An undescended testicle doesn't cause pain or other symptoms. The scrotum may look a little smoother or less developed on one side, or the side without a testicle may look smaller and flatter. You can't feel the testicle in the scrotum on the side where it hasn't descended.

Usually doctors recommend a wait-and-see approach for newborns. If the testicle hasn't dropped on its own within 6 months, your doctor may recommend surgery (orchiopexy or orchidopexy). Surgery is usually recommended by the time the baby is 18 months old. It is safe and effective and has few risks. Most babies recover quickly.

When babies have a testicle that can't be felt, doctors may do a different surgery that needs only a small cut (laparoscopy).

Doctors usually find an undescended testicle during a newborn exam. The doctor will check your baby again at age 3 months and 6 months. If the testicle hasn't dropped or can't be felt, a surgery called laparoscopy may be needed. A blood hormone test may be done if both testicles aren't in the scrotum.

• Have your child take medicines exactly as prescribed. Call your doctor if you think your child is having a problem with his medicine. You will get more details on the specific medicines your doctor prescribes.
• Go to all doctor visits so that the doctor can check your child for problems. This is important. Even if the testicle moves into the scrotum, sometimes it moves back out of the scrotum. If this happens, your child will need surgery.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the surgery may be canceled. If the doctor told you to have your child take his or her medicines on the day of surgery, have your child take them with only a sip of water.
• Have your child take a bath or shower before you come in. Do not apply lotion or deodorant.
• Your child may brush his or her teeth. But tell your child not to swallow any toothpaste or water.
• Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
• Be sure your child has something that reminds him or her of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by an anesthesia provider.
• The surgery will take about 1 hour.
• After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery room staff will monitor his or her condition. The doctor will talk to you about the surgery.
• You will probably be able to take your child home 2 to 4 hours after surgery.

Doctors don't really know what causes an undescended testicle. This common condition runs in some families (can be inherited).

As a baby boy grows inside his mother, he develops testicles. Early in his development, his testicles are in his belly. Normally, before he is born, his testicles move down into his scrotum, the sac that hangs below the penis. When one testicle does not move into the scrotum as it should, the baby has an undescended testicle. In rare cases, both testicles are undescended.

It is most common in baby boys who were born before their due date or who were very small at birth.

Most of the time, the testicle descends (drops) on its own by the time the baby is 3 months old. If your baby's testicle hasn't dropped by the time he is 6 months of age, your doctor may suggest treatment.

Treatment is important because having an undescended testicle increases the risk of:

• Infertility. Damage to a testicle's sperm-making ability can begin as early as 12 months of age. That's why many doctors advise treating an undescended testicle by the time a baby is 1 year old and no later than age 2. Treatment helps lower the chance of infertility.
• Cancer of the testicles. Men who were born with undescended testicles have a higher rate of testicular cancer than other men. But this cancer is rare. It can be cured if found early. If you are a young man who was born with an undescended testicle, talk with your doctor about what you should do.