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As a baby boy grows inside his mother, he develops testicles. Early in his development, his testicles are in his belly. Normally, before he is born, his testicles move down into his scrotum, the sac that hangs below the penis. When one testicle does not move into the scrotum as it should, the baby has an undescended testicle. In rare cases, both testicles are undescended.
It is most common in baby boys who were born before their due date or who were very small at birth.
Doctors don't really know what causes an undescended testicle. This common condition runs in some families (can be inherited).
Most of the time, the testicle descends (drops) on its own by the time the baby is 3 months old. If your baby's testicle hasn't dropped by the time he is 6 months of age, your doctor may suggest treatment.
An undescended testicle doesn't cause pain or other symptoms. The scrotum may look a little smoother or less developed on one side, or the side without a testicle may look smaller and flatter. You can't feel the testicle in the scrotum on the side where it hasn't descended.
At newborn and well-baby visits, your doctor will check your baby's scrotum.
Some other conditions are closely related to undescended testicles, such as an ectopic or retractile testicle. In both of these conditions, the testicle is in an abnormal position in the groin or scrotum. Your doctor will take care to make the correct diagnosis so your child can get the right treatment.
Usually doctors recommend a wait-and-see approach for newborns. If the testicle hasn't dropped on its own within 6 months, your doctor may recommend surgery (orchiopexy or orchidopexy). Surgery is usually recommended by the time the baby is 18 months old.footnote 1 It is safe and effective and has few risks. Most babies recover quickly.
When babies have a testicle that can't be felt, doctors may do a different surgery that needs only a small cut (laparoscopy).
Treatment is important, because having an undescended testicle increases the risk of:
Kolon TF, et al. (2014). Evaluation and treatment of cryptorchidism: AUA guideline. Journal of Urology, 192(2): 337-345. DOI: 10.1016/j.juro.2014.05.005. Accessed August 16, 2017.
Other Works Consulted
Barthold JS (2012). Abnormalities of the testis and scrotum and their surgical management. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 4, pp. 3557–3596. Philadelphia: Saunders.
Pettersson A, et al. (2007). Age at surgery for undescended testis and risk of testicular cancer. New England Journal of Medicine, 356(18): 1835–1841.
Walsh TJ, et al. (2007). Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. Journal of Urology, 178(4, Part 1): 1440–1446.
Zeitler PS, et al. (2014). Endocrine disorders. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 22nd ed., pp. 1054–1096. New York: McGraw-Hill.
Current as of: December 19, 2018
Author: Healthwise StaffMedical Review: John Pope, MD, MPH - PediatricsAdam Husney, MD - Family MedicinePeter Anderson, MD, FRCSC - Pediatric Urology
Current as of:
December 19, 2018
Medical Review:John Pope, MD, MPH - Pediatrics & Adam Husney, MD - Family Medicine & Peter Anderson, MD, FRCSC - Pediatric Urology
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