Undescended Testes (cryptorchidism) in Children

  • Undescended testicles—a condition also called cryptorchidism—is actually fairly common. However, the name is a bit misleading, which is why it is sometimes also referred to as “undescended testicles.”

    Here’s why: An undescended testicle is a testicle that never moves downward from the abdomen into the scrotum (the bag of skin hanging behind and under the penis). A undescended testicle does come down—just not completely. That’s what we see in most cases. Mal-descent can affect one or both testicles.

    • Undescended testicles, or cryptorchidism, is a painless condition.

    • The condition is congenital (meaning it is present at birth).

    • One to two percent of male infants are affected. Premature babies are affected by undescended testicles at a higher rate.

    • The more premature your baby is, the higher the chance of having an undescended testicle.

    • Testicles that do not descend into the scrotum are more prone to injury or testicular torsion (when the blood supply is cut off), rendering the testicle unviable.

    • In some cases—about 20 percent—an undescended testicle will resolve itself (or “drop”) on its own within your child’s first three or four months of life. Those that don’t will require surgery.

    Parents of baby boys who’ve been diagnosed with undescended testicles often worry, “Will my son be able to have children of his own?” Fortunately, the answer is yes in most cases for boys with one undescended testicle.

     Long-term consequences are rare, but you should be aware of them:

    • Undescended testicles may increase the risk of infertility, especially if both testicles are affected. However, boys who have one undescended testicle tend to ultimately father children at the same rate as those who are not affected by the condition at all.

    • Boys who have two undescended testicles—a much lower percentage of patients— do have a significantly lower fertility rate.

    • Undescended testicles are slightly more prone to develop testicular cancer, even after corrective surgery. However, surgery may reduce the risk of developing cancer. Parents should know that cases of cancer related to undescended testicles are rare.

    How Children’s Hospital Boston approaches undescended testicles

    Here at Children’s, we treat boys with undescended testicles in our Department of Urology. In fact, we have a dedicated Andrology Program within the department that focuses specifically on male hormone and reproductive disorders. (Andrology is the field of urology that studies and addresses conditions involving testicular function).

    The laparoscopic advantage

    In most cases, undescended testicles cannot be felt by hand. Boston Children's Hospital was the nation’s first hospital to use laparoscopy—a minimally invasive surgical procedure that involves looking into the abdomen with a very small telescope—to locate a testicle.

    • Boston Children’s Hospital is home to a Center for Minimally Invasive Surgery. Here at our center, we develop and refines surgical procedures that use tiny incisions and miniaturized, highly sensitive operating tools, cameras and telescopes.

    • Boston Children’s does more laparoscopic procedures than any other center in New England.

    • Our physicians also use laparoscopy to move a testicle into the scrotum. This permits the best growth and development possible for that testicle.

    • Most importantly, our clinicians are well-practiced in both laparoscopy and the treatment of undescended testicles in general: every week, we help as many as three to four kids with the condition. 

    Undescended testicles/cryptorchidism: Reviewed by Marc Cendron, MD
    © Boston Children’s Hospital , 2011

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