Undescended Testes in Children
Overview
Undescended testes means 1 or both of the male testes have not passed
down (descended) into the scrotal sac. This is a condition seen in some newborn baby
boys. Most cases involve only 1 teste. About 1 in 10 cases affect both testes.
Causes
Undescended testes are more often
seen in babies who are born early (preterm or premature babies). This is because the
testes don’t pass down from the belly into the scrotal sac until month 7 of a baby’s
growth in the uterus. Other causes may include hormone problems or spina bifida.
It may be caused by a reflex that causes a testicle to move up and down from the scrotum
back into the groin (retractile testes). In some cases, the testes are missing. In
rare cases, a boy who has inguinal hernia repair may develop undescended testes.
Risk Factors
This condition occurs in about 3 in
100 to 1 in 20 male babies. A baby is more at risk if he:
- Is born before 37 weeks of pregnancy
(preterm)
- Is small for gestational age
- Is low birth weight
- Has a family member with the
condition
Symptoms
Symptoms can be a bit different in
each child. The most common sign is when a healthcare provider can’t feel the testes
during an exam. Most children don't have symptoms when they have an undescended
testicle.
Diagnosis
The healthcare provider will ask about your child’s symptoms and health history. He
or she may also ask about your family’s health history. Your child's provider will
examine your child's scrotum for testes at every well-child check. In some cases,
imaging tests such as ultrasound or MRI are needed to find the testicles within the
pelvis.
Treatment
Treatment will depend on your
child’s symptoms, age, and general health. It will also depend on how severe the
condition is. In many cases, the testes descend on their own into the scrotum by age
3
months. In most cases, the testes pass down by age 6 months without any treatment.
In other cases, treatment may be needed. This may include:
-
Surgery.The undescended testicle may be moved into the scrotal sac with surgery. This
surgery is called orchiopexy. It’s often done between ages 6 and 18 months. It works
for most children.
-
Hormone
therapy.
Certain hormones may trigger the body to make testosterone.
This helps the testes descend into the scrotal sac. This treatment is only used in
some cases. Talk with your child’s healthcare providers about the risks, benefits,
and possible side effects of all medicines.
Talk with your child’s healthcare provider about what kind of treatment is advised
for your child.
Complications
If testes don’t descend, this can cause problems such as:
-
Infertility. This is most common when both testes don’t descend.
-
Risk for
testicular cancer.
This risk increases greatly by age 30 or 40. Men with undescended tests will
need to do monthly testicular self-exams.
-
Inguinal
hernia.
This is a weakened area in the lower belly wall or inguinal
canal where intestines may push through.
-
Testicular
torsion.
This is a painful twisting of the testes that can decrease
blood supply to the testes.
-
Emotional
stress.
An empty scrotum can cause emotional upset to boys and
men.
When to Call a Healthcare Provider
Call the healthcare provider if your baby has no sign of testes in his scrotal sac.
Key Points
- Undescended testes means 1 or both of
the male testes have not passed down into the scrotal sac. This is a condition seen
in some newborn baby boys.
- A baby is more at risk if he is born
before 37 weeks of pregnancy (preterm), or has a family member with the
condition.
- In many cases, the testes descend on
their own into the scrotum by 3 months old. In most cases, the testes descend by age
6 months without any treatment.
- In other cases, surgery or hormone therapy may be needed.
- If testes don’t descend, this can cause problems such as infertility, higher risk
of testicular cancer, and other problems.
Next Steps
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.