Undescended testes, also known as cryptorchidism, occur where one or both testes have not descended into the scrotum. It occurs in around 5% of boys and is screened for during the newborn baby checks at birth and 6-8 weeks.
During fetal development, the testes develop in the abdomen and then gradually migrate down through the inguinal canal and into the scrotum. They have normally reached the scrotum before birth.
An undescended testicle might be palpable in the inguinal region if it has exited the abdominal cavity but not fully descended to the scrotum.
The testes will descend in most cases by 6 months. The longer it takes, the less likely it will happen spontaneously.
Prolonged undescended testes increase the risk of:
- Testicular torsion
- Infertility
- Testicular cancer
Risk Factors
- Family history of undescended testes
- Low birth weight
- Small for gestational age
- Prematurity
- Maternal smoking during pregnancy
Management
Bilateral impalpable testes (not felt in the scrotum or inguinal region) require an urgent senior review.
For newborns where at least one testicle is palpable, repeated assessments are required at 6-8 weeks and 4-5 months. Referral to paediatric urology is indicated if both testes are not fully descended by 4-5 months.
Orchidopexy (surgical correction of undescended testes) is performed at 6-12 months of age.
Retractile Testicles
A retractile testicle is normally sited in the scrotum but moves up and into the inguinal canal when the cremasteric reflex is activated. This is considered a normal variant and usually resolves with puberty. Rarely, it may fully retract or fail to descend and require surgical correction (orchidopexy).
Last updated April 2025
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