Cryptorchidsm / Undescended Testes

What is cryptorchidism?

Cryptorchidism (or undescended testes) is a condition seen in newborns when one or both of the male testes have not passed down into the scrotal sac. Thirty percent of cases involve both testes. Cryptorchidism is more common in premature males because the testes do not descend from the abdomen to the scrotal sac until the seventh month of fetal development.

What causes undescended testes?

Undescended testes (or testicles) may occur for several reasons. While prematurity is a leading cause, other causes are hormonal disorders, spina bifida, retractile testes (a reflex causing a testicle to move back and forth from the scrotum to the groin), or testicular absence.

Who is affected by undescended testes?

  • Undescended testes occur in approximately 3 percent of full term male infants.
  • Up to thirty percent of premature male infants have an undescended testis.
  • There is a genetic component: 6 percent of fathers of boys with undescended testes also had the condition.
  • In rare cases, boys who undergo an inguinal hernia repair may develop undescended testes due to scar tissue.

What are the symptoms of undescended testes?

A testis not palpable in the scrotal sac (not found upon examination) is the most common symptom of cryptorchidism. However, each child may experience symptoms differently. Symptoms of cryptorchidism may resemble other conditions or medical problems. Always consult your child's doctor for a diagnosis.

How are undescended testes diagnosed?

Diagnosis is made based on a complete medical history and physical examination.

What is the treatment for undescended testes?

In two thirds of boys, undescended testes resolve without any intervention by the time the infant is 6 months old. Resolution occurs as the testes descend from the inguinal canal—a small internal passageway that runs along the abdomen near the groin—into the scrotal sac. If the testes have not descended by 6 months old, they may not do so at all.

We determine specific treatments for undescended testes based on:

  • child's age, overall health, and medical history
  • child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • extent of the condition
  • your opinion or preference

Treatments may include:

  • Hormonal therapy entails administration of certain hormones to stimulate production of testosterone, which helps the testes descend into the scrotal sac. This is not routinely used for treatment of truly undescended testes.
  • Surgical repair is an operation to locate the undescended testicle and advance it to the scrotal sac. Called orchiopexy, the surgery is usually performed in children between 6 and 18 months old and is successful in 98 percent of our patients.

If cryptorchidism is not repaired, these complications may occur as your child grows and matures:

  • increased risk of testicular cancer
  • infertility (most common in bilateral cases, where both testes are affected)
  • inguinal hernia (a weakened area in the lower abdominal wall or inguinal canal where intestines protrude)
  • psychological consequences associated with an empty scrotum
  • testicular torsion (painful twisting of the testes that decreases blood supply to the testes)
  • Risk of inguinal hernia