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An undescended testicle happens when one or both of the testicles do not travel to the scrotum before the birth of the baby. It is a fairly common occurrence in preterm male infants and occurs in about three to four percent of full term male infants. In most cases, the testicle that has failed to travel to the scrotum will do so by the age of nine months. If a testicle has descended on any given examination, it is considered to be descended even if on subsequent examinations it is found retracted up into the pelvis.

Retraction of the testicles can happen on a regular basis. This is due to the cremasteric reflex-a reflex that retracts the testicles that is really strong. It is basically normal and occurs as a result of fear or cold. While it happens in some males and not in others, it is considered normal and does not lead to the side effects of an undescended testicle. It does not need surgery and the testes are in the scrotum at some times and yet not at other times.

Testicles that are not descended at the age of one year need careful evaluation. Most studies suggest that surgery be done at this time because an undescended testicle can result in permanent damage to the testicle by this time. Later cancer of the testicle can happen if the testicle is not put into the scrotum by one to two years of age.

Testicles that don't normally descend into the scrotum are abnormal testes. They have a risk of infertility and cancer later in live even if they are brought into the scrotum during a surgical event. This is because the damage to the testicle is likely to happen even in infancy. If the doctor brings the scrotum into the testicle, the sperm count can go up and fertility is usually normal after awhile. The patient can check for cancer of the testicle better once the testicle is brought back into the scrotum.

There is another condition, called "vanished testicle" that occurs when the surgeon looks for an undescended testicle but cannot find it at all. The testicle never developed in utero and only the vestiges of a testicle exists that cannot be seen by the naked eye.

There are not any specific symptoms of an undescended testicle. If left unchecked, fertility can be a problem and later cancer of the testicle is a likely occurrence. For this reason, an undescended testicle should be replaced into the scrotum or should be removed to prevent later cancer from occurring.

Doctors can diagnose the undescended testicle by a careful physical examination. The doctor might be able to feel the tip of the testicle in the abdominal area above the scrotum. Sometimes it takes several examinations to make sure the child does not have an overactive cremasteric reflex rather than an undescended testicle. Both testicles can be undescended in some cases.

The treatment of undescended testicle is watchful waiting for the first year of life. If it does not occur spontaneously, the child can receive B-HCG injections or testosterone injections to allow the testicle to pass into the scrotum. If this doesn't work, then surgery in the form of an orchiopexy can be done in order to surgically place the testis into the scrotum.

The prognosis of an undescended testicle is good if it is treated. There is always an increased risk of testicular cancer later in life. About five percent of patients will be found to have a vanished testicle at the time of surgery.

Complications of undescended testicles include infertility and testicular cancer. Surgery can damage the testicle and can contribute to the problem of infertility of the testis.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here