Undescended testicle (testicle): cause, treatment

An undescended testicle is a testicle that has remained in the inguinal canal or in the abdominal cavity. In normal development, the testicle often descends before birth. From the inguinal canal to the scrotum. Are there any adverse consequences if a testicle has not descended and how is an undescended testicle treated?

Article content

  • Testicle (also called testicle or testis)
  • Undescended testicle
  • Adverse consequences if a testicle has not descended
  • Retractile testis
  • Causes of undescended testicle
  • Diagnosis of undescended testicle
  • Treatment of undescended testicle
  • Undescended testicle surgery
  • Prognosis of undescended testicle(s)

Testicle (also called testicle or testis)

The testicle is part of the male reproductive organs. The epididymis is located at the top and back of the testicle. The testes hang in the scrotum on a spermatic cord. They produce testosterone from puberty onwards. Testosterone is a male sex hormone and promotes the development of secondary and tertiary sexual characteristics: male hair, beard growth and a deeper voice. Sperm cells also grow in the testes, and they end up in the epididymis through tubes.

Undescended testicle

An undescended testicle is a testicle that has not descended into the scrotum before birth. Normally this happens before birth: the testes descend from the abdomen and enter the scrotum. About three in a hundred boys have one ball that doesn’t land. In two out of three cases, this ball will descend automatically within a year. It is almost never about two balls.

Adverse consequences if a testicle has not descended

If action is not taken in time, there is a slightly increased risk of testicular cancer. Furthermore, the chance of reduced fertility is slightly greater. A testicle can only produce healthy sperm cells in the scrotum. The temperature is too high in the groin or abdomen.

Retractile testis

It may be that a testicle has descended but is easily retracted into the inguinal canal. Especially in a warm environment, the testicle will enter the scrotum. Usually no treatment is necessary.

Causes of undescended testicle

The cause is unknown. The descent only takes place late in the pregnancy (from the sixth month) and is therefore more common in premature boys. It is not yet fully known how exactly the descent takes place. For a good descent process, it is important that the testicle has developed normally. Testes that have not descended often look abnormal.

Diagnosis of undescended testicle

The testicles of a newborn are always checked and if they have not descended, they are checked regularly. If both testicles can no longer be felt in a boy, he should be referred immediately to a pediatrician. It is sometimes difficult to determine whether a boy has an undescended testicle, because most boys’ testicles pull up in the abdomen when cold or touched.

Treatment of undescended testicle

If the testicle(s) is/are just above the scrotum, a doctor may have to wait a while. If the testicle has still not descended after the sixth month, this will not happen again and surgery will be required, preferably around the first birthday, but certainly before the second birthday. During the operation, the testicle is placed in the scrotum and secured: orchidopexy .

Undescended testicle surgery

The operation always takes place under anesthesia. If no ball is felt, keyhole surgery is started. The camera is inserted through the navel. Depending on what is seen, the operation can then be continued to insert the testicle into the scrotum. The operation is done during a hospital admission or day treatment. This depends on the age and overall health of the child. Whether the testicle has not descended on one or both sides also plays a role.

Prognosis of undescended testicle(s)

The operation allows the testicle to develop optimally. Despite the operation (at a young age), normal function of an undescended testicle cannot be guaranteed. Particularly if both balls had not descended, reduced fertility may occur later.