In this section
Testes (testicles) are male sex glands. They produce sperm and hormones for sexual reproduction. The testes are usually situated in the scrotum, but sometimes one or both of the testes do not move down into the scrotum once they develop. This is called undescended testes, and
is also known as cryptorchidism (kript-ork-id-izm).
About five per cent of male babies are born with undescended testes.
The main sign of undescended testes is one testis (a single testicle) or both testes missing from the scrotum. Undescended testes will not cause your child any problems with urination, and will not cause any pain, unless the cord attached to the testis (spermatic cord) becomes twisted.
The testes in a male foetus are formed inside the abdomen. The testes move down a tube called the inguinal canal and into the scrotum. This usually happens in the eighth month of pregnancy. A baby or child with undescended testes will have one or more of their testes located in the groin
or abdomen instead of the scrotum.
There are two types of undescended testes: congenital and acquired.
Babies born without testes in the scrotum have congenital undescended testes.
Usually doctors cannot find the cause; however, some hormone and genetic disorders can cause undescended testes.
In babies born early (premature babies), the testes may not have had time to move down into the scrotum by the time the baby is born.
Sometimes a child is born with the testes in the scrotum, but they develop undescended testes later. As the child grows, the spermatic cord fails to grow at the same rate. It ends up too short, and pulls the testis back up into the groin. This can happen between one and 10 years of age.
If your baby is born with undescended testes, this will be picked up by your Maternal and Child Health Nurse or your doctor shortly after birth. Your baby's condition will be monitored.
If your baby's testes were in the scrotum at birth, and one or both of them disappears from the scrotum, see your GP. You will be referred to a paediatrician or paediatric surgeon. It is very important that the testes be brought down to the scrotum.
If the testes do not come down, there is a risk of ongoing health issues such as:
For babies born with undescended testes, the testes may come down by themselves in the first three months after birth, and no treatment is needed.
If the testes do not come down by themselves, your child will be monitored, and if they are not down after six months, an operation called an orchidopexy (ork-id-o-peck-see) is needed. An orchidopexy brings the testis down into its normal location in the
scrotum. Orchidopexy is done under anaesthesia.
During surgery, a small cut is made in the groin and the cord is gently stretched to free up the testis. A second cut is made in the scrotum and the testis is secured inside the scrotum. The cuts are then stitched up. This operation is usually a day procedure and your child should be
able to go home on the same day.
Complications from orchidopexy are rare, but may include:
After your child's surgery, you will be given some post-operative care instructions. Contact your child's surgeon or the hospital if:
You may need to give your child pain relief – paracetamol is usually enough. See our fact sheet
Pain relief for children.
Limit your child's activity for the first few days after surgery – the surgeon will advise you of when your child can return to their normal activities.
An appointment will be made for your child to see their surgeon after the operation. Regular checks may be needed to make sure the testicle remains in the scrotum. Your child will need to learn how to do regular testicular self-examination when they become a teenager.
Sometimes when I'm changing my baby's nappy I notice that
his testicle seems to disappear. Is this undescended testes?
From about six months of age, male babies develop a reflex
that temporarily pulls the testicles up to protect them if your baby is cold or
frightened. If your baby's testicles are in the scrotum at other times then
this is not undescended testes, and your baby won't need surgery. See your GP
if you are concerned about your baby's testes.
How likely is it that my son will have reduced fertility
when he grows up?
About 10 per cent of males who undergo surgical
correction experience reduced fertility later in life. This is because the
testes do not produce sperm if they are stuck in the groin or abdomen. The
testes need to be cooler than body temperature for sperm production, which is
why they are located in the scrotum.
Developed by The Royal Children's Hospital Paediatric Urology and Surgery departments. We acknowledge the input of RCH consumers and carers.
Reviewed March 2018.
This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.