Undescended testes (known medically as cryptorchidism) occur when one or both of the testicles do not reach the scrotum and remain inside the abdomen or groin (inguinal canal). In New Zealand the condition occurs in approximately 4% of newborn boys and occurs more commonly in premature babies. The exact cause of the condition is unknown.
In the majority of cases a testicle that is undescended at birth will naturally correct itself by the age of three months. If a testicle is still undescended after three months of age it is unlikely that it will descend naturally and surgery to move it to its correct position in the scrotum may be required.
Testes need to be in an environment that is a few degrees cooler than the rest of the body. If a testicle does not descend into the scrotum, the warmer environment inside the abdomen or groin can cause it to develop abnormally. The testicle may fail to grow (atrophy), sperm production may be affected (possibly contributing to a reduction in fertility), and there is an increased risk of testicular cancer in later life.
DiagnosisAn undescended testicle is usually detected at birth. It may be recommended that the condition is regularly monitored to see if the testicle does descend. This may be done by a Plunket nurse or GP.
If the testicle hasn’t descended by approximately three months of age, a referral to a specialist may be made. The doctor will carefully examine the scrotum, groin and abdomen in order to locate the testicle. If the testicle is unable to be moved into the scrotum, or it retracts immediately, a diagnosis of an undescended testicle is likely to be made.
The surgery may be performed laparoscopically (“keyhole surgery”), or may require a small incision in the groin and scrotum. With both surgical techniques, the testicle is located, moved to the required position in the scrotum and stitched into place so that it does not retract. The incisions are closed with small dissolvable stitches.
After the operation the child will be given medication (such as paracetamol) for pain relief. The child will recover in the ward and most children are able to go home once they are eating and drinking. The doctor will recommend recovery and activity guidelines for the child and will advise how to care for the child’s wounds. Many children will be playing and active the day after the operation.
Newborn Services Clinical Guidelines (2013) Inguinal, Scrotal and Genital Problems in Neonates. Auckland District Health Board, Auckland
Wellington Children’s Hospital (2013) Undescended Testes (Pamphlet). Capital and Coast District Health Board. Wellington
Last Reviewed – 9 September 2013