Undescended Testis
Male babies in the womb develop the testes in the abdomen. In the months before they are born, the testis slowly makes its way down through the groin and into the “scrotum”, the sac that holds the testes.
This means that most baby boys, when they are born, will have two testes in the scrotum. (Sometimes they may take time to come down, so your pediatrician may wait up to 6 months of age to see if they do descend.)
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What happens if they don't come down all the way, or at all?
This means that some babies have the testis…
…in the tummy or abdomen,
…in the groin,
…or a little bit above the scrotum.
Some babies have them in places other than these three areas, and these are then called “ectopic testes.”
So what’s the problem if one testis is not in the scrotum?
The scrotum is considered the “best environment” for the testis.
It has the best temperature suitable for the testis to grow and function, and also allows the testis to be in an area that is easily felt or touched, allowing the testis to be examined regularly.
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If a testis is not in the scrotum, it may be exposed to higher temperatures, or may just be in an environment that it is not suitable for it to grow.
This can compromise the growth of the testis, and the function it can contribute to the boy’s fertility or hormone health.
Moreover, unfortunately, some boys with the testis staying in the abdomen have a risk of developing testicular cancer.
What can we do?
The first step is for your urologist or pediatrician to do a good physical exam to figure out the location of the testis.
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Some testes are just normally “retractile”, or able to go up and down the groin. These testes do not normally need surgery.
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Some testes remain in the groin. These patients will need surgery (“orchidopexy”) to “fix” the testis in the proper place.
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Please visit our page on orchidopexy for more information.
What if the testis can’t be found?
What if the testis can’t be found?
What do we do for a testis that could be in the abdomen?
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Your doctor may suspect that the testis is in the abdomen if it cannot be felt on a good physical exam under experienced hands.
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The best course of action is to do an examination under anesthesia with a possible diagnostic laparoscopy.
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Under anesthesia, with all the patient’s muscles relaxed, a good physical exam is performed again.
If the testis still cannot be felt, a small camera is inserted in the bellybutton to locate the testis. If a testis is found, it can be brought down to the scrotum gradually. This may take more than one stage or procedure to do.
“What if there is no other testis found?”
“What if we found the undescended testis too late and now there is just one good testis?”
“What if there is no other testis found?”
“What if we found the undescended testis too late and now there is just one good testis?”
We often reassure parents that one good, normal testis is enough for boys to have normal sexual and hormonal function. Please have a good and open conversation with your urologist about your concerns.
“What are the situations where you need to remove the testis?”
In older boys and men who have had their testes stay in the abdomen, it may be advisable to remove the remnant of the testis. This is to prevent the possibility of its developing into testicular cancer.
Take home messages
Your pediatrician has an important role in ensuring that both testes are felt in the scrotum as the child develops through the first few months of life.
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We encourage a referral to an urologist if the testis is found not to be descended after 6 months of life.
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If you have questions about the procedures for finding or fixing down the testis, please don't forget to visit our page on orchidopexy for more information!
The information in this infographic is for general information purposes only.
We encourage you to seek an individualized consult for the most appropriate management. You may book an appointment with us or with your preferred pediatric urologist or pediatric surgeon.
Please feel free to send us a message for questions on pediatric urologic health!
