Undescended Testicle

Undescended testicles, or cryptorchidism, is a disorder whereby a baby boy’s testicles do not move down (descend) into place in the scrotum, the bag of skin hanging below the penis. During pregnancy, the testicles of a baby boy form inside the abdomen and naturally descend into the scrotum before birth. However, in some cases, this doesn’t happen naturally, and the baby is born with ‘undescended testicles’. The testicles may remain in the abdomen or may only descend partially. Because of this, you may not see the baby boy’s testicles where they are supposed to be. In most cases, only one testicle is affected (unilateral), though both testicles may also be undescended in certain cases (bilateral).

This disorder is more common in baby boys born prematurely or those born with a low birth weight. A family history of this disease, Down syndrome, alcohol use or smoking by the mother during pregnancy or obesity or diabetes in the mother puts a child at greater risk of being born with undescended testicles. 

In most cases, the testicles descend on their own by three months of age, but if that does not happen, treatment is recommended as untreated undescended testicles can lead to further long-term complications, such as fertility problems, testicular cancer, hernia or damage to the testicle if it’s in a part where it will be subjected to pressure. 

Undescended testicles are not a painful condition, and do not affect fertility if treated. ​

In most cases, the undescended testicle appears as an empty scrotum sac, with no testicles visible. This will be identified in the first physical examination of your baby boy after birth. There is no pain associated with this disorder.

If you observe that one or both of the testicles of your baby boy are not visible, you must seek professional medical advice from one of our highly qualified paediatricians working with the Children’s Hospital Service Line at The Aga Khan University Hospital. You can be sure of receiving personalized treatment and care for the diagnosis and management of your baby boy’s undescended testicles.​​

Since the absence of testicles in a baby boy can be upsetting for parents, you must see your child’s paediatrician working with the Children’s Hospital Service Line at The Aga Khan University Hospital if you notice an empty scrotum in your baby. Usually, the testicle will descend on its own by the time your baby is four months of age. However, in case that does not happen, the problem will require treatment. 

Early treatment of undescended testicles can prevent further complications later in life. In some cases, previously visible testicles may disappear, indicating a case of ‘acquired undescended testicles’. Anything different or irregular about your baby boy’s testicles must not be ignored, and you must consult your child’s paediatrician immediately. ​

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

A detailed testicular examination will be employed by your child’s paediatrician to make an initial diagnosis of this disorder. The doctor will also feel the abdominal wall to check for the presence of an undescended testicle there. 

However, this physical examination may be difficult and the paediatrician may not be able to locate your child’s testicles. In that case, a diagnostic surgical procedure, called a laparoscopy, will be done to identify the exact location of the baby’s testicles. In this procedure, a small camera is inserted through an incision in your child’s abdomen. In some cases, the paediatric surgeon may be able to treat the disorder during this procedure, while it may also form part of the initial surgical treatment. Sometimes, a larger incision may have to be made for diagnosing this disorder directly without a laparoscopy. ​

Usually, undescended testicles descend on their own within the first three to four months of a baby’s life. However, if they haven’t descended by the time the baby boy is four months old, your paediatrician may refer you to a paediatric surgeon for further treatment.

Surgery is the primary treatment option for undescended testicles, with the aim of moving the undescended testicle to its proper place. This procedure may be performed as a laparoscopy as an open surgery, and should ideally be performed while the child is between six months to a year old. Early treatment of undescended testicles lowers the risk of further complications, such as testicular cancer or <infertility>. However, the paediatric surgeon will make a decision on the time of the surgery based on the child’s general health and the location of the testicles.  

Post-surgical monitoring is very important for ensuring thorough recovery after the procedure. Physical examinations, ultrasounds and hormone tests will help monitor your child’s post-surgical recovery. 

In some cases, the testicular tissue may be poorly developed or abnormal, because of which the surgeon may have to remove it altogether. If one or both of your son’s testicles have to be removed, you could be recommended testicular prostheses that can be implanted during childhood or adolescence. Hormone treatments may also be prescribed if both of the testicles have been removed.

As with any surgical procedure, make sure you discuss the possible risks and complications before agreeing to it. Your paediatric surgeon working with the <Children’s Hospital Service Line> at The Aga Khan University Hospital will inform you in detail about the risks of surgery and answer all your queries and concerns. 

It is recommended that examination of the testicles be conducted even after the corrective surgery, which you can discuss further with your doctor. ​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage​.

​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.