Undescended testicles (also known as cryptorchidism) is a condition in which one or both of a baby boy’s testicles (testes) have not moved down into their proper place in the scrotum. This condition is noticed either by a paediatrician or by parents when the scrotum is empty.
As a baby boy grows inside his mother’s womb, his testicles form inside his abdomen and move down (descend) into the scrotum shortly before birth. But in some cases, that move doesn’t happen, and the baby is born with one or both testicles undescended. The majority of cases are in male babies born prematurely.
Undescended testicles move down on their own in about half of these babies by the time they are 3-6 months old. If they don’t, it’s important to get treatment. The testicles make and store sperm, and if they don’t descend they could become damaged. This could affect fertility later in life or lead to other problems like being prone to injury or undergoing a torsion, where a testis twists upon itself and could become damaged. It is also important to note that testis which does not descend normally are more prone to develop cancer in adulthood. Your doctors will discuss these problems with you in detail.
Doctors usually diagnose cryptorchidism during a physical examination at birth or at a check-up shortly after, by identifying an empty scrotum. Most undescended testicles can be felt or “palpated” by the examining doctor. In a few boys, the testicle may not be located or palpated and may appear to be missing. In some of these cases, the testicle could be inside the abdomen, which requires further investigation.
If a testicle has not descended on its own by the time a baby is 6 months old, he should be checked by a pediatric surgical specialist. Often, your surgical consultant will diagnose a Retractile Testis, which does not generally need surgery at this age. If confirmed to be an Undescended Testis, surgical treatment is recommended, which involves locating and repositioning the testicle into the scrotum. The surgical options according to the position of the undescended testis are: Standard orchidopexy, where a cut is made in the groin, the testis found, and located and fixed in the scrotum, and Laparoscopic orchidopexy, where the testis is located by means of a laparoscope. This is usually done for testes that cannot be felt on examination. Laparoscopy may allow the testis to be brought down in a single stage or may nee4d two stages for a successful operation. Please meet your pediatric surgical consultant to know more details.
Dr Amrish Vaidya | Senior Consultant | Paediatric Surgery | SRCC, Children’s Hospital, Mumbai