Undescended Testicles on Children

Undescended Testicles also commonly known as “cryptorchidism”, in which one or both testicles fail to descend from the abdomen into the scrotum by age one. Undescended testicles is a common childhood problem that affects about a third of premature babies and 3 percent of full-term infants. Incomplete testicle descent is not just a physical abnormality; it also can lead to infertility and testicular cancer later in life.

Normally, the testicle will descend by the time a child is born, or by the end of the first year of life. However, if the testes remain in the abdomen, sperm production (and fertility) is usually impaired. If not repaired by age six, the condition can cause permanent infertility.

If only one testicle has descended, the boy will have a low sperm count, whereas if both remain in the abdomen, there is usually no sperm in the semen. Researchers believe that this is because the higher temperature in the abdomen destroys the enzymes and proteins needed for normal sperm production. There are several types of cryptorchidism. In true undescended testes, the testicles are positioned within the normal route of descent, but they cannot be manually lowered into the scrotum.

“Retractile testes” usually occurs between age three and six and is caused by hyperactivity of the abdominal muscles that raises the testes. Ectopic (displaced) testes are found outside the normal route of descent in areas such as the upper groin, floor of the pelvis, penile shaft, or thigh. Many researchers believe there is less chance of cancer in ectopic testes than in true undescended testes.

Causes of Undescended Testicles

Most cases of undescended testicles have no known cause.

Undescended Testicles Symptoms

Undescended testicles should be suspected if the testis cannot be felt in the scrotum, or if the testis is very soft and small.


Undescended Testicles Treatment

Doctors disagree about whether to treat this condition surgically or with hormonal therapy, although most experts recommend some form of treatment between a child’s first and second birthday. In the United States most doctors prefer to treat one undescended testicle with surgery, placing the testis in the normal position before the second birthday, so that it has a chance of developing normally and producing sperm cells. If both testicles are undescended, many specialists prefer a combination of surgery and hormone therapy with human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone (GnRH) or both.


European doctors usually rely on hormone therapy alone as the primary treatment for all patients with undescended testicles. Unfortunately, if the testes have been injured by their failure to descend, this usually cannot be corrected. Men with undescended testicles are more likely to have hormone problems or abnormal testicular ducts. Some doctors report improvements in sperm quality among men who receive medical therapy with clomiphene citrate (an antiestrogen drug) and hCG

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