Cryptorchidism; Empty scrotum - undescended testes; Scrotum - empty (undescended testes); Monorchism; Vanished testes - undescended; Retractile testes
Undescended testicle occurs when one or both testicles fail to move into the scrotum before birth.
Most of the time, a boy's testicles descend by the time he is 9 months old. Undescended testicles are common in infants who are born early. The problem occurs less in full-term infants.
Some babies have a condition called retractile testes and the health care provider may not be able to find the testicles. In this case, the testicle is normal, but is pulled back out of the scrotum by a muscle reflex. This occurs because the testicles are still small before puberty. The testicles will descend normally at puberty and surgery is not needed.
Testicles that do not naturally descend into the scrotum are considered abnormal. An undescended testicle is more likely to develop cancer, even if it is brought into the scrotum with surgery. Cancer is also more likely in the other testicle.
Bringing the testicle into the scrotum can improve sperm production and increase the chances of good fertility. It also allows the provider to do an exam for the early detection of cancer.
In other cases, no testicle may be found, even during surgery. This may be due to a problem that occurred while the baby was still developing before birth.
Most of the time there are no symptoms other than the absence of the testicle in the scrotum. (This is called an empty scrotum.)
Exams and Tests
An exam by the provider confirms that one or both of the testicles are not in the scrotum.
The provider may or may not be able to feel the undescended testicle in the abdominal wall above the scrotum.
Imaging tests, such as an ultrasound or CT scan, may be done.
In most cases, the testicle will descend without treatment during the child's first year. If this does not occur, treatment may include:
- Hormone injections (B-HCG or testosterone) to try to bring the testicle into the scrotum.
- Surgery (orchiopexy) to bring the testicle into the scrotum. This is the main treatment.
Having surgery early may prevent damage to the testicles and avoid infertility. An undescended testicle that is found later in life may need to be removed. This is because the testicle is not likely to function well and could pose a risk for cancer.
Most of the time, the problem goes away without treatment. Medicine or surgery to correct the condition is successful in most cases.
In about 50% of males with undescended testicles, the testicles cannot be found at the time of surgery. This is called a vanished or absent testis. As stated earlier, it may be due to something while the baby was still developing during pregnancy.
When to Contact a Medical Professional
Call your child's provider if he appears to have an undescended testicle.
Barthold JS, Hagerty JA. Etiology, diagnosis, and management of the undescended testis. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 148.
Chung DH. Pediatric surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 66.
Elder JS. Disorders and anomalies of the scrotal contents. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 545.
Meyts ER-D, Main KM, Toppari J, Skakkebaek NE. Testicular dysgenesis syndrome, cryptorchidism, hypospadias, and testicular tumors. In: Jameson JL, De Groot LJ, Krester DM, eds, et al. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 137.
Last reviewed on: 8/26/2017
Reviewed by: Jennifer Sobol, DO, urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.