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Undescended Testicle (Cryptorchidism)

What is an undescended testicle?

Undescended testicle (cryptorchidism) is a condition that affects about 3% of full-term baby boys and up to 30% of premature baby boys.

This occurs when one or both testicles do not descend into the scrotum. If the condition is left untreated, it can lead to potential long-term complications.

There are several possible causes of cryptorchidism, including hormonal problems, genetic abnormalities, and intrauterine compression.

Who gets an undescended testicle?

The exact cause of undescended testicles is unknown, but it is thought to be due to a combination of genetic and environmental factors.

The condition is more common in certain families, and boys born prematurely or with low birth weight are also at increased risk.

What problems can occur?

If undescended testicles are not treated, it can lead to fertility problems later in life. When the testicles are in the abdomen, they are warmer than needed. This can affect the quality of the sperm and decrease sperm production.

Another complication of an undescended testicle is an elevated risk of hernias. Hernias happen when an organ or tissue pushes through an opening in the surrounding muscle wall.

Hernias can be painful, and if they're not treated, they can cause serious health problems. Surgical intervention is the only way to fix a hernia. Undescended testicles can lead to tumor growth, as the testicles cannot properly regulate their temperature. Tumors are more likely to grow in warmer environments, so boys with undescended testicles need surgery as soon as possible.

How is an undescended testicle diagnosed?

A doctor will perform a physical exam of the abdomen and genitals. They may also order an ultrasound or other imaging tests to get a better look at the testicles.

Sometimes, a blood test may be ordered to check hormone levels. Once a diagnosis is made, cryptorchidism treatment can begin. Depending on the severity of the condition, surgery may be required to move the testicles into their proper position.

In other cases, medication may be used to help encourage the descent of the testicles.

Undescended Testicle Treatment

The surgery to correct an undescended testicle is called orchiopexy.

During undescended testicle surgery for an undescended testicle, the surgeon will make a small incision in the groin area and gently push the testicle down into the scrotum. The surgeon will then sew the opening in the scrotum shut.

The surgery is typically performed on an outpatient basis, and patients can typically return home the same day.

When is surgery needed?

Surgery may be recommended if the testicle has not descended by six months of age.

The earlier the surgery is performed, the better. That’s because there is a greater risk of fertility problems later in life if the condition is not corrected.

What can I expect from surgery?

You will check in at the hospital or surgery center on the day of surgery. Your child will then be taken to the pre-operative holding area, where you will wait until it is time for your child to be taken back to the operating room.

The surgeon will meet with you to go over the procedure details and answer any final questions you may have.

Your child will then be given medication to help them relax and fall asleep. Once under anesthesia, the surgeon will make an incision in the inguinal skin crease and pull the testicals into the scrotum.

Any associated hernia between the abdomen and scrotum is closed at the same time.

What to expect after surgery

Immediately after surgery, your child will be taken to a recovery room, where they'll be monitored for a short time. Once stable, your child will be discharged home with aftercare instructions.

Your child will need to take it easy for the first few days after surgery but should be able to resume normal activities within a week or two. You'll likely have follow-up appointments with your doctor to ensure your child is healing properly.

Before you leave, your team will review specific things to do at home regarding your child's care. Please follow these guidelines:

  • Incision Care: Your child may have a transparent plastic or gauze dressing over their incision. Keep the area clean and dry.
  • Bathing: Your child may take a shower/shallow bath five days after surgery. Sponge baths are ok before the five days; however, incisions should not be underwater for at least one week.
  • Activity: Your child should slowly return to a limited activity level. Older children should be out of bed and walking — no running, bike riding, or playing sports until your doctor approves. Toddlers should not play with straddle toys for ten days after undescended testicle surgery.
  • Diet: Your child may go back to their regular diet. Nausea is not uncommon for the first day or two post-operations, but it will eventually pass. If your kid feels sick, give them small sips of clear liquids now and then (like juice or ginger ale).
  • Medication: Occasionally, after undescended testicle surgery, a prescription for pain medicine may be prescribed by your child's doctor. You may also be instructed to give acetaminophen or ibuprofen if approved by your doctor.