Retained testicles in children

What is an undescended testicle?

Undescended testicle, also known as cryptorchidism, means that one or both testicles have not descended into the scrotum. During foetal development, the testicles move from the abdominal cavity down into the scrotum, but this process may be incomplete. The testicles may be located in the groin, higher up in the abdomen or, in rare cases, may be undeveloped or very small. Cryptorchidism is another term for this condition, and it is relatively common in boys, particularly those born prematurely.

Why does an undescended testicle occur?

An undescended testicle may be caused by hormonal imbalances, genetic factors or mechanical obstacles during foetal development. The risk is higher in boys born prematurely, as the testicles normally complete their descent later in pregnancy.

When should an undescended testicle be operated on?

Undescended testicles are relatively common in newborns, but many descend naturally during the first few months of life. If the testicle has not descended into the scrotum after 3–6 months, a clinical assessment is recommended. Early treatment is important to support normal testicular development, preserve fertility and reduce the risk of conditions such as testicular cancer.

What are the risks of untreated undescended testicles?

Without treatment, the condition may lead to reduced fertility, an increased risk of testicular cancer and damage to the testicular tissue. Early diagnosis and treatment are therefore essential.

How is the diagnosis made?

The diagnosis of an undescended testicle is primarily made through a clinical examination, during which the doctor assesses the position of the testicles. If there is any uncertainty, diagnostic imaging such as an ultrasound may be used to locate them. In newborns with bilateral non-palpable testicles, further examinations may be necessary.

When should you consult a doctor?

You should consult a doctor if one or both testicles cannot be felt in the scrotum, or if a testicle can only be felt occasionally. Early assessment provides the best opportunity for appropriate treatment.

Does an undescended testicle affect fertility?

An undescended testicle may affect fertility later in life, particularly if the condition is not treated in time. The testicles depend on the lower temperature in the scrotum to produce normal sperm cells. When a testicle remains in the abdomen or groin, it is exposed to a higher temperature, which can gradually damage its sperm-producing function.

The risk is greatest in bilateral cryptorchidism, where neither testicle has descended into the scrotum. In unilateral cryptorchidism, where only one testicle is affected, fertility will usually be normal, particularly if the condition is treated early.

Surgery, known as orchidopexy, is therefore typically recommended before the age of one. Early treatment improves the chances of normal testicular development and may reduce the risk of impaired fertility later in life.

When an undescended testicle is treated at the appropriate time, most boys will grow up with normal hormone production and a good chance of having children as adults.

Does an undescended testicle increase the risk of testicular cancer?

Yes, an undescended testicle is associated with an increased risk of testicular cancer later in life. The risk is higher in men whose testicle has not descended into the scrotum, particularly if the condition was not treated early.

Although the risk is higher than in the general population, the overall risk of testicular cancer remains low. Most boys with an undescended testicle will never develop testicular cancer.



Surgery, known as orchidopexy, does not completely eliminate the risk, but it makes the testicle easier to examine and allows any changes to be detected earlier. Early treatment is therefore recommended to support normal testicular development, preserve fertility and make it easier to monitor the testicle later in life.

Treatment of an undescended testicle

Treatment for an undescended testicle is surgical and is known as orchidopexy. During the operation, the testicle is moved down into the scrotum and secured in place. The procedure is performed as day surgery and has a high success rate. After the operation, the child may experience mild tenderness and swelling but can usually return to normal activities quickly. Complications are rare but may include infection, bleeding or the testicle moving upwards again.

How is orchidopexy performed?



Orchidopexy is performed under general anaesthesia. The surgeon locates the testicle, releases it from any tissue or structures preventing its descent and positions it correctly in the scrotum.