Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2023;108(4):online

Related article: Cryptorchidism (Undescended Testicle)

What is an undescended testicle?

Testicles are part of the male body. They make male hormones and sperm. Usually, both testicles are inside the scrotum.

While baby boys are still growing inside the uterus, the testicles are inside the abdomen. They usually move down into the scrotum just before or after birth. If one does not move down into the scrotum, then it is an undescended testicle.

Up to 45% of boys born early and 4% of boys born on time have at least one undescended testicle. If your newborn baby has an undescended testicle, it will usually move down on its own in the first few months of life. If this doesn’t happen before six months, it may need to be treated by a doctor.

How do I know if my baby has an undescended testicle?

The doctor can check your baby’s scrotum. If the doctor can’t feel the testicles inside the scrotum, it’s called a nonpalpable testicle.

A nonpalpable testicle might be inside the abdomen, too small to feel, or not there at all. It is important to find out which one.

Imaging tests, such as an ultrasound, are not recommended. Surgery is usually needed to find the testicle.

Why does an undescended testicle need to be treated?

There are two reasons to treat an undescended testicle. First, undescended testicles may not make sperm. Testicles are in the scrotum because the temperature there is cooler than it is inside the body. A cooler temperature helps the testicles make sperm. A man’s ability to make sperm can be lost in early childhood if the testicle doesn’t move down into the scrotum.

A baby boy can start to lose the ability to make sperm by 12 months of age. Getting the testicle down into the scrotum before puberty can give him a better chance of having children when he grows up.

Second, an undescended testicle is more likely to develop cancer. When the testicle is inside the scrotum, a man can easily feel his testicles to check for a tumor, or he can be checked by his doctor. This way, any tumor can be found early, when the cancer is easier to treat.

How is an undescended testicle treated?

It depends on where it is located. Babies with a testicle that can be felt in the groin (the area where your thigh meets your body) usually get an operation called orchiopexy (say: OR-key-oh-PECK-see). The operation is done through a small cut in the groin to move the testicle down into the scrotum. It takes about one hour. Babies who have this operation usually go home the same day. Most babies get better very quickly.

If you are an adult with an undescended testicle, moving the testicle to the scrotum probably won’t improve your ability to make sperm. So, in adult men, an undescended testicle is usually taken out. Most doctors don’t recommend treating an undescended testicle in men older than 40 years.

If you have an undescended testicle, your doctor can help you decide what to do.

Where can I get more information?

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