Navigating Undescended Testicles: A Guide for Parents

Testicles produce and store sperm. If they do not descend, it is called cryptorchidism or undescended testicles. It is a state of being where a male child’s testicles (one/both testes) have not suspended into the scrotum.

To figure out the presence of this condition, a doctor will conduct several tests. If there is any anomaly, the doctor will prescribe treatment. In most cases, testicles move into the scrotum within six months from the child’s birth after the trigger reaction subsides. However, if it doesn’t, it becomes necessary for the patient/parents to seek treatment.

Anyone can suffer from undescended testicles. So, it becomes essential to look for any signs and how to seek treatment for the same. This article aims to shed light on undescended testicles, their symptoms, diagnosis, and treatment.

A] What Are Undescended Testicles?

During pregnancy, the foetus’s testicles evolve. Closer to parturition, the testes reach the groin. If everything goes right, the testicles drop down into the scrotum, beneath the penis. However, sometimes, things might not take the natural course of action during pregnancy. 

Undescended testicles are an innate condition that occurs in one to two percent of male infants. Prematurely born male infants are at a high risk of getting affected by this condition. 

Unlike normal testes, which are inside the scrotum and 3-5 degrees cooler, the undescended ones may be located anywhere between the abdomen and groin. Additionally, the heat inside the body impairs either one or both testes. Later, it affects the sperm quality and the overall health of the boy.

Parents of such infants are concerned about the future and fertility of the child. Fortunately, people with one undescended testicle can cope with fertility. In other cases, undescended testicles lead to fertility issues.

B] Causes Of Undescended Testicles

The experts haven’t yet discerned the exact cause of undescended testicles. However, the majority of cryptorchidism is seen among preterm male babies. Other common factors observed in such infants are:

• Abnormal Anatomy
• Hormonal Imbalances
• Environmental Influences

It is important to understand the causes of undescended testicles because it might follow some side effects. For instance, one side effect of undescended testicles is that the brother of a boy with such a condition is 7.5% likely to be affected by the same. This probability rises to 25% if the brother is an identical twin.

Many parents opt to bring out the testes and it remains one of the common causes for surgery in children. Proper detection and timely treatment can save these children from late-life difficulties.

C] Forms Of Undescended Testicles

There are mainly four forms of undescended testicles that occur commonly in children and adults. The below-mentioned are the top forms: 

1. Congenital 

This type of undescended testicles occurs in the womb such that a testis/both never drop into the scrotum. Congenital undescended testicles are usually diagnosed at birth.

2. Acquired 

Acquired undescended testicles are defined when the testicles are inside the sac at birth. Later, the testicles’ positions change abruptly.

3. Retractile Testicle

This is a temporary case of testicular retraction. Retractile testicles occur due to cold temperatures or muscle reflexes. In this condition, the testicles retreat to the groin area. Such a condition needs no surgery but timely treatment 

4. Vanishing Testicle

Vanishing testicle is the condition when there is no presence of a testicle in the scrotum, groin, or abdomen. In this condition, one testicle can manage normal needs and will support fertility.

D] How Are Undescended Testicles Diagnosed?

Usually, a person has no discomfort or undescended testicle pain. There may be an underdeveloped/small scrotum. Or, if one of the testicles has descended, it may appear asymmetrical. In the case of retractile testicles, it temporarily disappears based on a trigger.

To treat this condition, doctors conduct a full genitalia examination to locate the testicle(s). For further examination, the patient may be sent to a urologist or a pediatric surgeon to figure out the condition and suggest a small testicle treatment. 

Based on the complete diagnosis, the doctor will prescribe a treatment. It is crucial to get this condition treated because it is a common cause of surgery in children and has changed the lives of many.

E] Treatment Options For Undescended Testicle Repair

Below mentioned are a few treatment options for testicle repair treatment. 

1. Surgical Treatment (Orchiopexy)

Orchiopexy is a type of undescended testicle surgery used to relocate the testis into the scrotum. This procedure is also known as Orchiopexy. The procedure may be performed as a two-pronged process as per the testicle’s location.

The main aim of this surgery is to:

• To relocate the testicle into its natural position inside the scrotum.
• To reduce the risk of probable hormone and fertility risks.
• To reduce the risk of testicular cancer

Orchiopexy is an easy procedure that doctors often perform as an outpatient treatment. Many patients prefer minimal invasive laparoscopy for undescended testis. This ensures that there are only minor to scarce incisions, reduced scarring, and speedy recovery. 

Furthermore, such a surgery paves the way for the natural development of the testicles and drastically reduces the risk of cancer, infertility, and future complications. 

2. Hormonal Therapy

In some cases of undescended testicles, the testis can be stimulated to descend naturally. The doctor will examine the patient to see whether he is fit for hormone therapy.  Accordingly, they will decide to administer hormones such as human chorionic gonadotropin (HCG) or gonadotropin-releasing hormone (GnRH). After the procedure, the patient is closely monitored and checked for reactions.

Many patients also choose other urologic disorders treatment strategies to supplement their undescended testicle repair. Patients take up these strategies as a supplementary measure to aid their treatment.

F] Complications Of Undescended Testis Surgery

The complications of undescended testis are minimal to very rare. It is very common and one of the most effective treatments for undescended testicles. 

However, very rarely the testis might again retreat to the groin. This condition warrants another surgery. In some cases, testis might lose blood supply rendering it non-viable.