Undescended Testis

In a baby boy, the testicles develop in the abdomen and normally move down into the scrotum before birth. Undescended testis means one or both testicles have not moved down into the scrotum. It is common in preterm babies and usually corrects by 6 months. It is also called cryptorchidism.

Keeping the testis inside the abdomen is harmful because body temperature is too hot for it. If not treated, it can cause:

• Infertility later — reduced sperm production
• Increased risk of testicular cancer in adult life
• Torsion or hernia — risk of the testis twisting, or a hernia
• Psychological issues in the teenage years

Early surgery gives the best results.

• An empty scrotum on one or both sides
• Sometimes the testis can be felt in the groin
• Retractile testis: comes down with a warm bath but goes up when cold — this is normal and not a problem

Check at birth and during every vaccination visit.

• Physical examination by a paediatric surgeon
• Ultrasound — to find the location of the testis if not felt
• Hormone tests — rarely needed

Surgery is the treatment — medicines and hormones do not work. The operation is called orchidopexy.

• Best age: 6 months to 18 months; latest by 2 years
• A day-care procedure of 45–60 minutes under general anaesthesia
• The testis is brought down into the scrotum and fixed there
• Laparoscopic surgery is used if the testis is inside the abdomen
• Success rate: over 95%

Delaying beyond 2 years reduces fertility potential.

• Pain: mild for 2–3 days; pain medicine is given
• Bath: after 48 hours
• Activity: no running or cycling for 2 weeks
• Follow-up: check at 1 week, 3 months and 1 year
• Scar: very small, fades over time