Undescended Testis

Q: Will an operation repair my son's undescended testis?

A: About 4% of all newborn boys have a testis that has not fully descended into the scrotum. By the first birthday, about 1% of boys still have an undescended testis (cryptorchidism). It is now known that if the testis has not descended by the first birthday, it will not do so thereafter. The majority of boys with an undescended testis need to have an operation to bring the testis down into the scrotum. The operation is called orchiopexy.

A distinction must be made between a retractile testis, which can be drawn into the groin and requires no treatment, and the true undescended testis, which requires surgery. The diagnosis of an undescended testis begins with the observation that a testicle (or both testicles) is absent from the scrotum. If a testis was in the sac and disappears, it may be retractile. Various reports have shown that there is a slightly higher chance of the undescended testis developing a tumor. It is recommended that even after surgery, regular examination of the testis be done to be sure the testis stays healthy.

Surgery is usually performed between the ages of 6 and 18 months. Pediatric urologists have shown that the longer the testis stays out of the scrotum, the more likely it may be damaged, so the operation is being performed earlier than in previous years. It is important that a pediatric urologist evaluate the boy with an undescended testis.

Surgery is done for several reasons. If left uncorrected, the higher temperature of the body may inhibit the normal growth of sperm in the undescended testis. Furthermore, the undescended testis is more vulnerable to injury. In addition, an empty scrotum may cause worry and embarrassment. Finally, if untreated, an undescended testis may change and form a tumor.

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