Undescended Testes

The testicles normally are located in the abdomen before birth in male babies. Undescended testes happens when the testicle fails to descend into the scrotum after birth.

What causes undescended testes?

The descent of the testicles occurs as a result of many factors. Occasionally, the testicles do not move completely down to the scrotum and remain in the abdomen or in the groin area. Undescended testes is found more commonly in babies who are born early or have certain birth defects, such congenital diaphragmatic hernia and abdominal wall defects (gastroschisis and omphalocele).

How is undescended testes diagnosed?

The diagnosis of undescended testes is made on examination by doctor or nurse right after delivery. Sometimes, ultrasound is done to locate the testicle when it is not felt in the groin area or scrotum on physical exam. Inguinal hernia is commonly found in babies with undescended testes. Inguinal hernia can also be diagnosed on physical exam by doctor or nurse.

How is undescended testes treated?

Observation

After birth, the testicle can still descend down to the scrotum without medical therapy. This can occur within the first year of life. Therefore, when undescended testes is diagnosed at birth, we do not recommend any surgical procedure to correct the condition right away. The timing of surgery can be between 6 to 12 months. The exact timing of surgery will be determined by your child’s surgeon.

Surgery

Undescended testes can be corrected with a surgical procedure called “orchiopexy,” where the testicle is surgically brought down to the scrotum. If the testicle is located in the groin area, a skin incision is made in the groin area to find the testicle and bring it down to the scrotum. If the testicle is located in the abdomen, operation will involve laparoscopy, where small telescope is placed in the abdomen to find the testicle. For both types of operation, your child will be placed under general anesthesia.

How long will my child be in the hospital?

Surgery for undescended testes is an outpatient procedure, which means your child comes to the hospital the day of surgery and goes home the same day. After surgery, your child will only need Tylenol or ibuprofen for a few days to treat any discomfort or pain.

What is the follow-up after surgery?

Swelling at the scrotum or groin incision site is common after surgery. The swelling will resolve after a couple of weeks. The risk of injury to the testicle is very low during surgery. It is important that your child is examined annually to make sure that the testicle remains descended in the scrotum after surgery. This exam can be done by your child’s pediatrician at well child visit.