Overview
Retractile testicle is a condition where a testicle moves back and forth between the scrotum and the groin. It usually occurs in boys during fetal development or shortly after birth. The testicle descends into the scrotum but does not remain in place due to an overactive muscle (cremaster muscle). The cremaster muscle pulls the testicle upward when it contracts, which can be stimulated by rubbing a nerve on the inner thigh, emotions like fear and laughter, or exposure to a cold environment. Retractile testicle is different from an undescended testicle (cryptorchidism), which is a condition where a testicle never enters the scrotum. Retractile testicles generally do not cause complications and are not associated with long-term health risks, except for a slightly increased risk of the testicle becoming an ascending testicle. If you have concerns about your son's testicle development, it is recommended to consult with a healthcare provider for evaluation and monitoring.
Understanding the disease
Symptoms
The symptoms of a retractile testicle include:
- The testicle can be moved by hand from the groin into the scrotum and doesn't immediately retreat to the groin.
- The testicle might spontaneously appear in the scrotum and remain there for a time.
- The testicle might spontaneously disappear again for a time. It's important to note that these symptoms are different from those of an undescended testicle (cryptorchidism), where the testicle never enters the scrotum. If you have concerns about your child's testicle development, consult their doctor for further evaluation and guidance.
Development
Retractile testicles typically develop due to an overactive cremaster muscle, which is a thin pouch-like muscle that holds the testicle. This muscle is responsible for pulling the testicle up towards the body. The cremaster muscle can be stimulated by rubbing a nerve on the inner thigh or by emotions such as fear and laughter. Additionally, exposure to cold temperatures can also activate the cremaster muscle, resulting in a retractile testicle. When the cremaster muscle contracts, it pulls the testicle out of the scrotum and up into the groin. In most cases, the condition resolves itself before or during puberty as the testicle moves to its proper location in the scrotum and stays there permanently. However, in some instances, the retractile testicle may remain in the groin and become an ascending testicle or an acquired undescended testicle.
Assessment and Diagnosis
Triage
You should see a doctor if retractile testicle is suspected during regular well-baby checkups and annual childhood checkups. If you believe your child has a retractile or ascending testicle, or have other concerns about the development of their testicles, it is important to consult with their doctor. The doctor will examine the testicles and determine the appropriate course of action, which may include scheduling regular checkups to monitor changes in the condition.
Diagnosis
A retractile testicle can be diagnosed through a physical examination by a doctor. During the examination, the doctor will locate the testicle in the groin and attempt to guide it gently into its proper position in the scrotum. If the testicle moves relatively easily and does not immediately return to its original location, it is likely a retractile testicle. If the testicle immediately retreats to its original location, it may be an undescended testicle.
Management and Treatment
Complications
The complications include a greater risk of the testicle becoming an ascending testicle.
Preparing for medical consultation
To prepare for an appointment for a retractile testicle, you should:
- Write down a list of questions to discuss with your child's care team, such as the frequency of appointments, how to safely check the scrotum at home, when to see a specialist, what tests are needed, and what treatment options are recommended.
- Be aware of any pre-appointment restrictions and ask if there's anything you need to do in advance.
- Write down any symptoms your child is experiencing, including any that may seem unrelated to the reason for the appointment.
- Note down any key personal information, such as any major stresses or recent life changes.
- Find out if there is a family history of fertility problems or other reproductive issues.
- Discuss with your child how to respond if he is teased or asked about the condition.
- Be prepared to answer questions on your child's behalf or help him answer questions during the appointment. Remember to mention any concerns or observations about the retractile testicle, including when you first noticed its absence in the scrotum and if your child has experienced any pain or trauma to the genitals or groin area.