Undescended testicle

Symptoms and causes

What is it?

When a male foetus is in the mother's womb, the testicles develop in the baby's abdomen. As the foetus grows, these testicles gradually descend to the lower abdomen. Then they ‘push’ themselves through the inguinal canal to arrive at their destination, in the scrotum, around the time of birth.

In 1% of the boys in their first year of life, the testicle does not descend. In these boys, the testicle is located in the abdominal cavity, in the inguinal canal or just above the scrotum.

An important distinction that should be made is the difference between a retractile testicle and a real undescended testicle. In the case of a retractile testicle, the testicle has travelled the entire route up to the scrotum, but sometimes it disappears upwards, towards the inguinal canal. An undescended testicle has never entered the scrotum.

Diagnosis and treatment

How is the diagnosis determined?

The diagnosis is made by clinical examination or ultrasound imaging.

In case of persistent doubt about the location of the undescended testicle, an abdominal keyhole surgery may be required.

If both testicles are found not to have descended, a blood test (HCG stimulation test) is recommended.

Treatment

A retractile testicle does not require any surgical treatment, unlike the real undescended testicle that has to be surgically placed into the scrotum. The testicle must be moved to the scrotum before the end of the second year of life. This is done under anaesthesia in an operation referred to as an ‘orchidopexy’.