TESTES, UNDESCENDED

General Information

DEFINITION--A disorder present at birth in which one or both testicles have not descended from the pelvis into their normal position in the scrotum. In some boys, they descend spontaneously without treatment by age 1.

BODY PARTS INVOLVED--One or both testes (testicles); scrotum; spermatic cord.

SEX OR AGE MOST AFFECTED--Male infants and children.

SIGNS & SYMPTOMS

• Scrotum appears undeveloped on one or both sides.
• Testicle can't be felt in its normal position in the scrotum.

CAUSES

• Unknown, but probably related to hormone deficiency in the mother or fetus.
• Presence of fibers that interrupt its route and cause it to remain in the groin.

RISK INCREASES WITH--Family history of undescended testes.

HOW TO PREVENT--No specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Ultrasound or CT scan (See Glossary for both) if testis cannot be felt.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Treatment will be determined by type of cryptorchidism. If the testis lies in the scrotum at times and then retracts occasionally, the problem normally resolves itself by puberty. Other forms are treated with hormones or by surgery.
• Surgery to move the testes into the scrotum. Surgery is the only treatment for those who don't respond to hormone treatment. Surgery ideally should be performed at a young age (less than 18 months) to help preserve reproductive function. (See Testicle Fixation in Surgery section.)

POSSIBLE COMPLICATIONS

• Increased possibility of testicular cancer.
• Sterility or reduced fertility rate.
• Psychological problems associated with an altered male self-image, if the problem is not corrected.
• Lack of normal sexual development, if testes are not present.
• Hernia development.

PROBABLE OUTCOME--Usually curable if treated with surgery or hormones. The prognosis for future fertility may be 80% if one testicle is involved and 50% if both are involved.

How To Treat

GENERAL MEASURES--

• If a testis appears to be missing after birth, check periodically to see if it has descended on its own accord.
• There is no need to discuss the problem with the child and cause him undue worry.

MEDICATION--Your doctor may prescribe human chorionic gonadotrophins by injection. These are usually given 3 times a week for 4 to 6 weeks. This treatment causes testes to descend normally in about 25% of cases.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

Your child has undescended testes. Call as soon as you identify this abnormality.