Retained testicles in children

What is testicular retention?

An undescended testicle (also known as retentio testis or cryptorchidism) means that one or both testicles have not descended into the scrotum. During fetal development, the testicles migrate from the abdomen down into the scrotum, but this process may sometimes be incomplete. The testicles may be located in the groin, higher up in the abdomen, or in rare cases, be undeveloped or very small. This condition is relatively common in baby boys, especially those born prematurely.

Why does testicular retention occur?

Undescended testicles can be caused by hormonal imbalances, genetic factors, or mechanical obstacles during fetal development. The risk is higher in boys born prematurely, as the testicles usually complete their descent later in pregnancy.

When should an undescended testicle be operated on?

n newborns, undescended testicles are relatively common, but many testicles will spontaneously descend during the first few months of life. If a testicle has not descended into the scrotum after 3 to 6 months, a clinical evaluation is recommended. Early treatment is important to ensure normal testicular development, preserve future fertility, and reduce the risk of later complications, such as testicular cancer.

What are the risks of untreated testicular retention?

Leaving the condition untreated can lead to reduced fertility, an increased risk of testicular cancer, and permanent damage to testicular tissue. Therefore, early diagnosis and treatment are crucial.

How is the diagnosis made?

The diagnosis of an undescended testicle is primarily made through a clinical examination, where the doctor checks the location of the testicles. If there is any doubt, imaging such as an ultrasound can be used to locate them. In newborns where neither testicle can be felt (bilateral non-palpable testicles), further medical evaluations may be necessary.

When should you seek medical attention?

If one or both testicles cannot be felt in the scrotum, or if a testicle can only be felt occasionally, you should seek medical attention. Early evaluation offers the best chance for successful treatment.

Does testicular retention affect fertility?

An undescended testicle can affect fertility later in life, especially if the condition is not treated in time. Testicles depend on the cooler temperature of the scrotum to produce healthy sperm. When a testicle remains in the abdomen or groin, it is exposed to higher body temperatures, which over time can damage its sperm-producing function.

The risk is greatest when both testicles are undescended (bilateral). When only one testicle is affected (unilateral), future fertility is often normal, especially if the condition is treated early.

Therefore, surgery (orchiopexy) is typically recommended before the age of 1. Early treatment improves the chances of normal testicular development and reduces the risk of fertility issues later in life. If treated promptly, most boys will grow up with normal hormone production and a healthy ability to have children as adults.

Does testicular retention increase the risk of testicular cancer?

Yes, having an undescended testicle is associated with an increased risk of testicular cancer later in life. The risk is higher in men whose testicles did not descend naturally into the scrotum, particularly if the condition was not addressed early.

However, while the risk is higher compared to the general population, the overall likelihood of developing testicular cancer remains low. The vast majority of boys with an undescended testicle never develop testicular cancer.



Surgery (orchiopexy) does not completely eliminate this risk, but it moves the testicle into a position where it can be easily examined for any changes early on. Early treatment is therefore recommended to support normal testicular development, preserve fertility, and make future routine checks much easier.

Treatment of testicular retention

The treatment for an undescended testicle is surgical and is called orchiopexy. During the operation, the testicle is brought down into the scrotum and secured. The procedure is performed as day surgery and has a high success rate. After the operation, the child may experience slight soreness and swelling but quickly returns to normal activities. Complications are rare but can include infection, bleeding, or the testicle retracting back up.

How is orchidopexy performed?

An orchiopexy is performed under general anesthesia. The surgeon locates the testicle, frees it from any tissue causing obstruction, and places it correctly in the scrotum.