According to Dr. Satej Shankar Mhaskar, a highly trained Paediatric Surgeon and Paediatric Urologist at Surya Hospitals, Santacruz (Mumbai), it is a common condition. It affects 1.5-3% of term boys and up to 30% of preterm boys. It can be associated with other urological abnormalities.
It can be unilateral or bilateral.
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| Types | What Happens | Key Points |
| Congenital | A testicle that never descended into the scrotum. | Diagnosed at birth. |
| Ascended | A testicle that was in the scrotum at birth but later moved to an abnormal position. | May require evaluation to determine the cause. |
| Retractile testicle | The testicle is in the scrotum but can move up (e.g., into the groin) due to a muscle reflex. | Triggered by factors like a cold, it often doesn’t need surgery. |
It is important to differentiate an undescended testis from a retractile testis.
Retractile testis is in the scrotum but can move up (e.g., into the groin) due to a muscle reflex usually triggered by a change in temperature (cold) and emotional states like fear.
Retractile testis can be easily brought down to the scrotum and stays there momentarily when left; however, an undescended testis will spring back to the groin immediately when left due to the tension on the spermatic cord.
Testicles need to be in the scrotum because:
There are various factors responsible for it, which are hormonal, genetic, and structural.
Hormonal imbalance during fetal development, such as low levels of male hormones like testosterone, or issues with hormone signals from the brain. This can disturb the normal descent of the testicle into the scrotum.
Genetic mutations in
Changes in these genes can disturb the production or reception of reproductive hormones. This can affect the testicle's ability to descend. Other factors, like a family history of the condition, also increase risk.
Physical or structural issues, such as a shorter spermatic cord, abnormal nerve signals, or obstructions along the path, can block the testicle from moving down into its normal position.
According to Satej Shankar Mhaskar, in most babies, the testicles generally come down on their own by the time they’re 6 months old. However, if they haven’t by then, it’s unlikely they will move down naturally afterwards; hence, treatment or undescended testicle surgery (like open orchidopexy) is required.
The choice of surgical procedure is based on the clinical location of the testis.
The doctor can diagnose undescended testicles during a physical examination at birth or shortly after birth.
Open orchidopexy is done.
In open orchidopexy surgery, the testicle is gently freed (mobilised) along with its sperm duct and blood vessels. It is then fixed in the scrotum at the right position.
Diagnostic laparoscopy is used.
A check-up is generally done after 6 months to see if the testicle is in place and developing properly.
Both procedures are safe and effective with a desirable success rate when done under professional care. However, the success rate depends on individual factors and the severity of the condition.
According to studies, it has a success rate of about 90-95%
According to studies, it has a success rate of about 85-90%
It’s important to note that every child has a unique body structure; hence, recovery times may vary. Follow your doctor’s instructions on managing your child’s pain and discomfort.
Unfortunately, there's no known way to prevent undescended testicles. The best approach is careful observation and timely surgery when advised by reliable doctors like those at Surya Hospitals, Santacruz (Mumbai), along with regular follow-ups to ensure proper development and reduce fertility and other complications.
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