Undescended Testis

In boys, the testes (testicles) begin their development in the abdomen (tummy). Whilst the baby boy is growing and developing in his mother's womb, the testes gradually travel down in to the scrotum (testes sack). At birth, most boys have two testes in the scrotum. However, in some babies, one or both of the testes cannot be felt in the scrotum. The testis will then be 'undescended'. It is usually 'stuck' somewhere in the lower abdomen.

Yes, some will still descend even after birth. However, this is less likely the older the baby becomes. If it is not down by the age of 3 to 6 months, it is unlikely to descend on its own.

Doctors will often check the scrotum in routine baby checks. As it is important to be sure they are 'down' this quick examination may be done two or three times during childhood. Sometimes if the child is cold (or examined by cold hands) it can be difficult to detect the testes as they may 'ride up' high in the scrotum. Sometimes a testis which seems to be absent will be felt at a later date.

The reasons why it is important to diagnose undescended testes are:

• Cosmetic reasons. Most boys would prefer to have two testes and look normal when they are grown up.
• Fertility. If the testis is left in the abdomen there is a high chance it will become infertile when adult.
• Cancer. The risk of developing cancer of the testis in adulthood is higher if the testis is left in the abdomen.

What is the treatment?

If one or both testes are not detected at any check, then usually the baby or child is referred to a specialist. Sometimes, if the child is under six months of age, some time is given to see if it descends on its own. There is no need to rush into having surgery in the very young. However, if the child has passed the age of about 6-12 months and the testis is still not down, then an operation is usually recommended.

The operation is routine and straightforward in most children. The surgeon will make a small cut to locate the testis and then pull it down. Once down it then stays down. The operation is done under general anaesthetic, and the child usually only needs a short stay in hospital.

© EMIS and PIP 2004   Updated: November 2002   CHIQ Accredited