What are undescended testicles?

Undescended testicles are when one or both of your baby’s testes have not fully descended (come down) into their scrotum.

The testicles (testes) are male sex organs. They make sperm and hormones.

The testicles form in the abdomen (tummy) of male babies during pregnancy. They usually descend into the scrotum during the eighth month of pregnancy.

In babies with undescended testicles, the testicles are still in the abdomen or groin instead of the scrotum. This condition is also called cryptorchidism.

The testicles often come down by themselves by the age of 3 months.

Undescended testicles affect about:

• 5 in 100 male babies at birth
• 1 to 2 in 100 male babies at the age of 3 months

Both testicles need to be in the scrotum for them to develop normally. If they don’t descend by 6 months, it’s important to get treatment to prevent future health problems.

What are the symptoms of undescended testicles?

The main symptom is that one or both testes are missing from your baby’s scrotum.

Undescended testes don’t usually cause pain unless the cord attached to the testis (the spermatic cord) is twisted.

Undescended testes should not be confused with retractile testes. This is when the testes temporarily pull up into the groin. This can happen when your baby or child is cold or upset. They will return to the usual position once your baby is warm or content again.

What causes undescended testicles?

In many babies, the cause of undescended testes is unknown.

There is an increased risk of undescended testes in:

• babies who are born prematurely
• low birth weight babies
• babies with family members who had undescended testicles
• babies exposed to cigarette smoking during pregnancy
• babies with some genetic conditions

Sometimes a baby is born with their testes in their scrotum, but they move up into the groin later. This can happen between the ages of 1 and 10 years. This condition is called ‘acquired undescended testes’ or ‘ascending testis’.

When should my baby see the doctor?

Undescended testicles are usually found as part of a routine check of your baby after birth.

Visit your doctor or baby health clinic if you can’t feel one or both testicles in your baby’s scrotum.

How are undescended testicles diagnosed?

Your doctor can diagnose undescended testicles during a physical examination.

Your doctor will ask whether the testicles have ever been felt in the scrotum. They will also ask about your baby’s health in general.

Your doctor will refer you to a paediatrician (specialist in child health) or paediatric surgeon.

How are undescended testicles treated?

If the testicles have not descended by 3 to 6 months, they are unlikely to come down by themselves.

In most cases, surgery will be recommended if:

• the testes don’t descend by themselves
• your child develops an undescended testicle

The operation for undescended testicles is called orchidopexy. During the procedure, the surgeon gently stretches the spermatic cord and brings the testicle down into the scrotum.

Your baby or child will have a general anaesthetic for the surgery. In most cases, your child will be able to go home on the same day as the procedure.

Your doctor will discuss with you the need for follow-up appointments and advise on regular testicular examinations.

What happens if undescended testicles are not treated?

It’s important to treat undescended testes. Problems that can arise from undescended testicles include the following.

• Reduced fertility later in life (because the testes need to be cooler than body temperature to make sperm, which is why they are normally located in the scrotum).
• Twisting of the spermatic cord, which can cut off the blood supply to the testes (testicular torsion).
• An increased risk of testicular cancer (although this is uncommon, affecting fewer than 1 in 100 boys with undescended testes).
• A type of hernia called an inguinal hernia.

Resources and support

If you think your baby has an undescended testicle, talk to your doctor or child health nurse.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.