Roughly 80% of cryptorchid testicles will descend by the time the infant is 3 months old.
Read on to learn more about cryptorchidism. This guide includes information about the causes and symptoms of undescended testicles. It also covers risk factors and possible complications.
The main symptom of an undescended testicle is an empty scrotum. A medical professional will usually detect this during the physical examination of the newborn baby or during a routine checkup within the first 6–8 weeks.
In around 80% of cases, cryptorchidism is unilateral. This means that it affects just one testicle. Bilateral cryptorchidism, which affects both testicles, is present in around 20% of cases.
Cryptorchidism does not cause any pain. It also does not affect urination.
If the testicle does not descend on its own within 6 months after birth, the infant may require surgery within a year.
If the surgeon can feel the testicle during a physical examination, they may perform scrotal or inguinal orchidopexy, also called orchiopexy.
If they cannot feel the testicle during a physical examination, abdominal orchidopexy or laparoscopic orchidopexy may be necessary.
During orchidopexy, the surgeon will move the undescended testicle into the scrotum. This procedure helps:
- reduce the risk of injury by crushing
- correct any associated hernia
- prevent or alleviate any psychological concerns
- preserve fertility
It is important to note that orchidopexy does not protect against testicular cancer. However, following orchidopexy surgery, it is easier for doctors to monitor for signs of cancer.
Medical professionals do not know exactly what causes cryptorchidism. Most babies born with an undescended testicle are otherwise healthy.
However, there are certain risk factors that may increase the likelihood of cryptorchidism. These include:
- premature birth before pregnancy week 37
- a low birth weight
- a family history of cryptorchidism
- certain conditions in the birthing parent, such as diabetes or obesity
- alcohol use during pregnancy
- cigarette use during pregnancy
- exposure to pesticides or phthalate
- preeclampsia
- in vitro fertilization
The presence of some conditions may also make cryptorchidism more likely. These include:
- Down syndrome
- Prader-Willi syndrome
- Noonan syndrome
- persistent Müllerian duct syndrome
Contact a doctor if you have concerns about the possible risk factors for cryptorchidism.
A medical professional will usually diagnose cryptorchidism during a physical examination after birth.
If you have concerns about cryptorchidism, contact a doctor as soon as possible. You should also contact a doctor if you notice that a child’s testicle is not in their scrotum. This is not painful, but a doctor will be able to monitor the condition and advise on treatments.
Sometimes, the testicles will move up and down. If you notice this, you can mention this at a regular appointment. It is not likely to be cryptorchidism.
Read our article on testicular pain for information about possible causes of testicular pain.
It is possible to diagnose cryptorchidism during a physical examination. This means that a medical professional can diagnose undescended testicles soon after the child is born.
If the doctor cannot feel the testicle, they may refer the child to a specialist or pediatric surgeon.
In these cases, laparoscopy may be necessary. This is a keyhole surgical procedure during which the surgeon will make a small incision in the abdomen to locate the testicle.
Complications may develop as a result of cryptorchidism.
For example, infertility may be possible, even after orchidopexy surgery. Around 10% of people with unilateral cryptorchidism will develop infertility. The same is true for around 38% of people with bilateral cryptorchidism. Learn more about male infertility.
An individual with cryptorchidism is also more likely to develop testicular cancer. They are three times more likely to develop testicular cancer than the general population if they undergo orchidopexy before puberty. However, they are five to six times more likely if orchidopexy takes place after puberty.
Seminoma is the most common type of testicular cancer for people with undescended testicles. Learn more about the types and stages of testicular cancer.
Contact a doctor if you have concerns about cryptorchidism. Undergoing orchidopexy surgery before the child is 12–18 months of age can help reduce the risk of some complications.
Testicles can respond to temperatures and emotions by moving in and out of the scrotum. “Retractile testicle” is a term used when the testicle does not stay descended.
While a retractile testicle is not usually a cause for concern, it may require monitoring in case it does not descend naturally.
Cryptorchidism occurs when one or both testicles are undescended. Unilateral cryptorchidism means that it affects one testicle, while bilateral cryptorchidism means that both testicles are undescended.
Treatment for cryptorchidism typically involves orchidopexy surgery, during which a surgeon will move the testicle into the scrotum. Doctors usually recommend this procedure if the testicle does not descend on its own within the first 6 months of the child’s life.
Contact a doctor if you have concerns about cryptorchidism. They will be able to carry out a physical examination and make a referral to a specialist where necessary.
