Undescended Testicle

Treatment Overview

If your newborn has an undescended testicle, your doctor will probably want to wait and see whether the testicle will descend into the scrotum on its own. Your doctor will examine your baby at each well-baby checkup to see whether the testicle has moved toward or into the scrotum.

If the testicle has not descended within the first 6 months, it is not likely to do so on its own. Your doctor will probably recommend surgery to move it into the scrotum, most likely when the baby is 9 to 15 months old.¹ In some cases, surgery can be done using laparoscopy, which requires only a small cut below the belly button. In others, open surgery is needed.

Surgery to move an undescended testicle into the scrotum is called orchiopexy or orchidopexy. It is considered a safe and effective procedure that has few risks.

• Depending on the location of the testicle, one or two small incisions are made in the scrotum, the groin, or the belly to allow the surgeon to reach the testicle and move it to the scrotum.
• Usually only one surgery is needed. But if testicles are located in the belly, your baby may need two separate operations, several months apart.
• If an inguinal hernia is also present, it will be repaired at the same time.
• Your baby will be given general anesthesia so that he sleeps through the procedure. After surgery, he will be watched for a while after he wakes up, and then he can go home. Most babies recover quickly.

Another possible treatment is hormone therapy. Hormone therapy may stimulate the testicle to complete its descent into the scrotum. If it works, surgery is not necessary.

• Hormone therapy alone is effective in less than 20% of cases.⁴ It may be a good option if the testicle is already very close to the scrotum.
• Sometimes, a testicle may only partially descend with hormone treatment. This may still be helpful because it may make the surgery easier to do.

The treatment your doctor recommends will depend on a number of factors:

• For babies, most doctors recommend treatment as early as 6 months of age but no later than 2 years of age. Early treatment between age 6 months and 1 year may help prevent infertility later in life.
• For a teen or adult who has an undescended testicle, surgery is generally recommended after puberty and up to about age 32. It makes it easier to check the testicle for cancer. After age 32, the risks of surgery are greater than the risk of cancer.⁵ If you have an undescended testicle, talk with your doctor about what is best for you.
• If an undescended testicle is incomplete or malformed in males up to about age 32, most doctors recommend that it be removed rather than placed in the scrotum.

What to think about

• A child who has only one testicle (because one is either absent or has been removed) should take special care to preserve it and protect it from injury. If surgery is required to move the single testicle to the scrotum, the testicle may be stitched in place. This can help reduce the risk of damage if testicular torsion develops later in life.
• Males who are born with an undescended testicle have about a 20 to 40 times greater risk than other males for developing testicular cancer.⁵ Treatment of an undescended testicle makes it easier for you or your doctor to find testicular cancer if it develops. Some experts say that early treatment for undescended testicle may lower testicular cancer risk.^{6, 7} But there has not been enough research to prove that this is true. For more information on this type of cancer, see the topic Testicular Cancer.
• Because of the risk of cancer, men who have ever had an undescended testicle should have regular medical checkups (at least once every 2 years) throughout life. These checkups should include a testicular examination. If you have ever had an undescended testicle, talk to your doctor about how often you need to be checked. Also, learn how to do self-examinations.
• An empty or partly empty scrotum can have a psychological and emotional effect on a male. Surgical treatment may improve his self-esteem. If the testicle is absent or malformed, a testicular prosthesis can help the scrotum appear and feel normal.

Go to previous section	Go to top of page	Go to next section
Author:	Douglas Dana Debby Golonka, MPH	Last Updated: July 30, 2007
Medical Review:	Anne C. Poinier, MD - Internal Medicine Michael J. Sexton, MD - Pediatrics Peter Anderson, MD, FRCS(C) - Pediatric Urology
© 1995-2008 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.