Undescended Testicle

One of the most common findings in newborn boys. Timing of treatment matters more than parents usually realize.

What it means

The testicles form in the abdomen and normally descend into the scrotum before birth. In an undescended testicle (cryptorchidism), one or both have not completed that journey. It is one of the most common congenital findings in boys, and considerably more common in those born prematurely.

It should be distinguished from a retractile testicle, which is in the scrotum but pulls up temporarily with cold or touch. Retractile testicles are normal and need no surgery, only periodic monitoring. Telling the two apart is a matter of examination.

Why timing matters

Some testicles descend on their own during the first months of life. After about six months, spontaneous descent becomes unlikely.

Current guidance recommends surgical correction between roughly six and eighteen months of age. The reason is that a testicle sitting outside the scrotum is at a higher temperature than it should be, and prolonged exposure affects the tissue responsible for sperm production. Earlier correction is associated with better fertility outcomes and makes the testicle easier to examine over a lifetime.

Undescended testicles also carry a modestly increased lifetime risk of testicular cancer. Surgery does not eliminate that risk, but placing the testicle in the scrotum makes self-examination possible — which matters for early detection later in life.

The surgery

Orchiopexy brings the testicle into the scrotum and secures it there. When the testicle can be felt in the groin, it is done through small incisions as an outpatient procedure, and children generally go home the same day.

When the testicle cannot be felt, laparoscopy is used to locate it. Depending on what is found, the repair may be done in one stage or two.

Recovery in small children is usually quick — most are back to normal within a few days. Avoid straddling toys, bicycles, and rough play for a couple of weeks.