Overview
An undescended testicle, also known as cryptorchidism, is a condition where one or both testicles fail to move down into the scrotum, the bag of skin that hangs below the penis, before or after birth. This can occur more often in premature babies and may require surgery if the testicle doesn't move down into the scrotum on its own within a few months after birth. Undescended testicles may lead to health problems later in life, such as infertility or an increased risk of testicular cancer.
Understanding the disease
Symptoms
The main symptom of an undescended testicle is not seeing or feeling the testicle in the scrotum. This usually occurs in babies shortly after birth during an examination. If the testicle hasn't moved into the scrotum by 3 to 4 months of age, it likely won't correct itself. Undescended testicles can lead to health problems later in life, such as testicular cancer and infertility. Fertility problems are more likely to occur in men who've had undescended testicles and may be more severe if left untreated for an extended period. Other health conditions associated with undescended testicles include testicular torsion, a painful condition where the testicle twists, cutting off blood flow to the affected area.
Risk Factors
Risk factors for developing an undescended testicle in a newborn include premature birth or low birth weight, family history of undescended testicles, health conditions in the baby such as cerebral palsy or a problem with the wall of the abdomen, the mother having diabetes before or during pregnancy, alcohol use during pregnancy, smoking cigarettes or exposure to secondhand smoke during pregnancy, and exposure to some pesticides during pregnancy.
Development
Undescended testicles can develop due to two main types: retractile testicles and ascending testicles.
- Retractile testicles: These testicles move back and forth between the scrotum and the groin due to a muscle reflex in the scrotum. They can be guided by hand into the scrotum during a physical exam. This is the most common type of undescended testicle.
- Ascending testicles: In this type, the testicle has returned to the groin and cannot be easily guided into the scrotum. Another term for this is acquired undescended testicle. Both retractile and ascending testicles are a result of an undescended testicle, but they differ in the position of the testicle and its movement. If you have concerns about your child's genitals or notice any changes, consult their doctor or care team for further evaluation and guidance.
Assessment and Diagnosis
Triage
If you suspect an undescended testicle in a baby, it's recommended to see a doctor shortly after birth. If the testicle hasn't moved into the scrotum by 3 to 4 months of age and doesn't correct itself, it's important to consult a doctor. Early intervention can help lower the risk of potential health problems later in life, such as testicular cancer and infertility.
Diagnosis
To diagnose an undescended testicle, your healthcare provider may perform a physical examination, especially during well-baby visits or regular exams for your child. If the testicle can be felt in the inguinal canal, the healthcare provider may attempt to gently move it into the scrotum. If the testicle moves only partially into the scrotum, causes pain during movement, or returns to its original location quickly, it may be an undescended testicle. A retractile testicle can be moved into the scrotum but might not stay there for a long time. If your child's testicle hasn't moved down or can't be found by about 6 months of age, you may need to see a specialist, such as a pediatric urologist or pediatric surgeon, for further examination. Imaging tests like ultrasounds or MRIs are generally not used to diagnose an undescended testicle, as the condition can usually be determined through physical examination.
Management and Treatment
Complications
Potential complications of an undescended testicle include testicular cancer, fertility problems, and testicular torsion. Testicular cancer is more likely to occur in men who have had an undescended testicle, and fertility problems might be more severe if left untreated for an extended period. Testicular torsion, a painful condition characterized by the twisting of the cord that brings blood to the testicle, can lead to testicular damage if left untreated.
Home Remedies
It's important to consult a healthcare professional for proper evaluation and treatment of an undescended testicle. Surgery is often recommended to move the testicle into the scrotum, and timely intervention can help reduce the risk of potential health complications, including testicular cancer and fertility problems.
Treatment
The treatment for an undescended testicle typically involves surgery. There are two main types of surgery: laparoscopy and open surgery. Laparoscopy involves a small tube with a camera being placed through a small cut in the belly to locate the testicle in the stomach area. In some cases, the surgeon might be able to fix the undescended testicle during the same procedure. However, another surgery might be needed. Open surgery uses a larger cut to look inside the stomach area or groin to find the undescended testicle. The goal of treatment is to move the undescended testicle to its proper place in the scrotum. Treatment before the age of 1 might lower the risk of health problems linked with an undescended testicle, such as infertility and testicular cancer. Surgery is generally recommended before the child turns 18 months old. Remember to consult with your child's healthcare provider to discuss the best treatment approach for your specific situation.
Preparing for medical consultation
To prepare for an appointment for an undescended testicle, you should:
- Write down a list of questions to discuss with your child's care team. These may include questions about the frequency of appointments, how to safely check the scrotum at home, when to see a specialist, what tests your child will need, and what treatment options are recommended.
- Gather any relevant medical records, test results, or notes about your child's condition.
- Be prepared to discuss any concerns or symptoms your child has experienced.
- Make a plan for your child's care and follow-up appointments, if necessary. Remember to be open and honest with your child's care team, and don't hesitate to ask any questions you may have. It's important to work closely with them to ensure the best possible care for your child.