Undescended Testis (Cryptorchidism)
Undescended testis, also known as cryptorchidism, is a condition in which a baby boy’s testicle does not move down into its natural position in the scrotum after birth. This condition is more common in premature babies, whose testicles may not have had enough time to descend before birth. In this article, we will cover all important details about undescended testis, including symptoms, diagnosis, complications, and surgical treatment options.
What Is an Undescended Testis?
During fetal development, a baby boy’s testicles form inside the abdomen. As the baby grows, the testicles gradually descend into the scrotum before birth. In some cases—especially in premature births—one or both testicles fail to descend, resulting in undescended testis (cryptorchidism).
What Are the Symptoms of Cryptorchidism?
Normally, a newborn’s testicles should descend into the scrotum within the first few months of life. If they do not, medical evaluation and treatment are necessary to prevent complications such as infertility or testicular damage later in life.
In older boys, one of the most noticeable signs is a missing testicle in the scrotum. This could indicate:
- Retractile Testicle:
A condition where the testicle moves back and forth between the groin and the scrotum. This can often be felt during a physical exam, as the testicle can be gently guided into the scrotum. It is caused by a natural muscle reflex.
Ascending Testicle (Acquired Undescended Testicle):
A testicle that had previously descended but has moved back up into the groin and cannot be moved back into the scrotum manually. This requires medical attention.
How Is Undescended Testis Diagnosed?
An undescended testis is often diagnosed at birth during a routine physical examination. The doctor will check whether both testicles are present in the scrotum.
- If the testicle is not palpable in the groin area, it may be located higher up in the abdomen, making it more difficult to detect manually.
- In such cases, a pelvic ultrasound or laparoscopy may be used to locate the undescended testicle.
Complications of an Undescended Testicle
Testicles are naturally positioned outside the body in the scrotum because they require a cooler environment than the rest of the body to function properly. If left untreated, an undescended testicle may lead to several complications:
- Testicular Cancer:
Men with untreated cryptorchidism have a higher risk of developing testicular cancer due to abnormal sperm cell development. - Fertility Problems:
A unilateral undescended testicle, if left untreated, may reduce fertility. The risk is higher with bilateral cases or delayed treatment. - Testicular Torsion:
Twisting of the spermatic cord can cut off blood supply to the testicle, causing severe damage and requiring emergency surgery. - Trauma:
Testicles located in the groin are more vulnerable to injury due to pressure from the pubic bone.
Inguinal Hernia:
A common complication where part of the intestine slips into the groin due to weak abdominal muscles. This condition is painful and requires surgical repair.
How Is Undescended Testicle Surgery Performed?
The surgery to correct this condition is called orchidopexy. The aim is to move the testicle into the scrotum to restore normal function and reduce the risk of complications.
- If the testicle is located in the groin, a small incision is made to access and reposition it into the scrotum.
- If the testicle is located in the abdomen, a laparoscopic surgery is performed. A thin tube with a camera (laparoscope) is inserted through a small incision to locate the testicle and guide it into the scrotum.
Both procedures are performed under general anesthesia, so the child is asleep and feels no pain during or after surgery. Recovery is typically quick, and the results are usually excellent.
