What Is an Undescended Testicle?
An undescended testicle (medically called cryptorchidism) occurs when one or both testicles are not located in the scrotum after birth.
Normally:
- Testicles develop in the abdomen during pregnancy
- Near birth, they pass through the inguinal canal
- They descend into the scrotum
If this descent does not occur, the testicle may remain:
- In the abdomen
- In the inguinal canal
- Rarely, in an abnormal location
How Common Is Cryptorchidism?
It is more common than many people think:
- 3–5% of full-term male infants
- 20–30% of premature infants
Some testicles descend naturally in the first months of life. However, any testicle not in the scrotum after 6 months must be evaluated.
Causes of Undescended Testicles
There is no single cause. Often, multiple factors play a role:
- Hormonal insufficiency
- Mechanical obstruction along the descent pathway
- Genetic predisposition
- Premature birth
- Developmental factors during pregnancy
Importantly, this condition is not caused by parental actions.
Symptoms and Signs
Most cases are painless, which can delay detection.
Common signs include:
- One side of the scrotum appearing empty
- Asymmetry of the scrotum
- Testicle not felt during bathing or examination
In older children, rarely:
- A fullness in the groin
- A testicle that moves with activity
Can an Undescended Testicle Descend on Its Own?
This is one of the most frequently asked questions.
- Some testicles descend spontaneously within the first 3–6 months
- After 6 months, spontaneous descent is unlikely
Therefore, waiting beyond this period is generally not recommended.
Why Is an Undescended Testicle Important?
It is not just a cosmetic issue. Without timely treatment, risks include:
- Permanent damage to testicular tissue
- Increased risk of infertility
- Higher risk of testicular cancer
- Testicular torsion
- Greater vulnerability to trauma
These risks are especially higher when the testicle remains in the abdomen.
How Is Cryptorchidism Diagnosed?
Diagnosis is usually straightforward:
- Physical examination is the most important step
- If the testicle cannot be felt, further evaluation is done
- Ultrasound may be used in selected cases
Note: Not every non-palpable testicle is truly undescended. Experienced clinical examination is crucial.
Treatment of Undescended Testicles
Treatment depends on the child’s age and the location of the testicle.
Surgical Treatment (Orchiopexy)
The most effective and permanent treatment is surgery:
- The testicle is positioned correctly
- It is fixed inside the scrotum
- Usually planned around 1 year of age
This procedure is called orchiopexy.
When Should Surgery Be Performed?
Current medical guidelines are clear:
- Ideal age: 6–12 months
- Latest recommended age: up to 18 months
Earlier surgery means:
- Better preservation of testicular function
- Lower long-term risks
Recovery After Surgery
- Typically a short and safe procedure
- Discharge the same day or the next day
Postoperative course:
- Mild pain or tenderness
- Return to normal activities within a few days
- Regular follow-ups to monitor testicular development
Can Undescended Testicles Be Diagnosed in Adults?
Yes. In rare cases, cryptorchidism is detected in adulthood.
In such cases:
- Testicular function is evaluated
- Cancer risk is assessed
- Treatment is individualized
This is why early childhood diagnosis offers a major advantage.
Undescended Testicle vs. Retractile Testicle
These two conditions are often confused:
- Retractile testicle: Can be brought into the scrotum during examination and is usually harmless
- Undescended testicle: Cannot be placed in the scrotum and requires treatment
Only a specialist can reliably distinguish between them.
Undescended Testicle Should Not Be Delayed
- Common condition
- Easily treatable when diagnosed early
- Delays can lead to serious complications
If scrotal asymmetry, emptiness, or suspicion is noticed, prompt evaluation is the best approach.
Frequently Asked Questions
Can an undescended testicle correct itself?
Some testicles descend naturally in the first 3–6 months. After 6 months, spontaneous correction is unlikely and specialist evaluation is required.
Is it usually one-sided or can it affect both sides?
It can be unilateral or bilateral. Bilateral cases carry a higher risk of infertility.
Does it cause pain?
Usually no. Lack of pain does not mean the condition is harmless.
What happens if it is left untreated?
Potential outcomes include infertility, testicular shrinkage, and increased cancer risk.
Is the surgery difficult?
No. It is generally a short, safe procedure with quick recovery.
Can it be diagnosed in adulthood?
Yes, though rare. In such cases, management is individualized based on risk assessment.
Don’t Delay If You Suspect Cryptorchidism
When evaluated and treated at the right time, most long-term risks can be significantly reduced. The “let’s wait a bit longer” approach does not always lead to good outcomes.
For clear guidance on follow-up and the most appropriate treatment timing, an expert evaluation by Doç. Dr. Serkan Doğan can help determine the best and safest plan for your child.