Undescended Testicles

What are undescended testes?

It is a disorder of boys in which one or both of the testicles (the male sex glands) have not descended into their normal position in the scrotum.

The testes develop inside the abdomen in the foetus and start their descent through the abdominal wall so that it is usually complete by a month before birth. The testes are attached to the body by long cords called spermatic cords.

How common is it?

It is a very common problem, present in about 4% of newborn males and as high as 25% in premature males. The exact cause is not known.

What happens in infancy?

Many undescended testes complete their descent during the first 12 weeks following birth, but after this time spontaneous descent is uncommon. Between one and two per cent of testes are still undescended at one year.

What are the symptoms?

Undescended testes cause no symptoms. It is not a painful condition and urination is normal. The scrotum appears undeveloped on the affected side and the testicle cannot be felt in its normal position.

What is acquired undescended testes?

Sometimes the testes are present in the scrotum at birth but with growth of the child the spermatic cord does not keep up with the general body growth. By about school age the testes are undescended and sit high in the groin.
undescended testicles
What are the risks?

If left untreated there is an increased chance of reduced fertility and sterility in some males. This is apart from the psychological effects of the altered male selfimage.

But the main concern is the risk of cancer in the undescended testicle which is up to 10 times greater than normal. The cancer eventually develops in adults 2540 years of age.

What is the treatment?

If the problem has not corrected itself in the first few months, early surgery is necessary to locate the testicle and bring it into the scrotum by freeing and stretching the spermatic cord to which it is attached.

The recommended time for this surgery is between six and 24 months of age, with 1218 months being the most popular time for surgeons to operate.

It is still acceptable to operate at 57 years if the diagnosis is delayed or the problem has developed after birth.

However, it has been shown the quality of sperm production diminishes from the age of two onwards in the undescended testicle.