Undescended Testicles in Baby Boys: Causes, Symptoms, and Treatment Options

Alan Lucks | MD

Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on February 29th, 2024.

Key Takeaways

  • Cryptorchidism affects 3-5% of full-term male babies and up to 30% of premature infants, with testicles normally descending from the abdomen into the scrotum by 32-36 weeks of pregnancy.
  • Most cases resolve naturally within the first 6 months of life as hormone levels stabilize, which is why doctors recommend watchful waiting until this milestone.
  • Orchiopexy surgery must be performed between 6-12 months of age for optimal outcomes—delaying beyond 18 months significantly increases complications and reduces success rates.
  • Boys with this condition face a 4-6 times higher risk of testicular cancer later in life, plus potential fertility issues affecting 10-15% of cases if left untreated.
  • Physical examination reveals an empty scrotum on the affected side, though some testicles may be "retractile" and temporarily pull up due to muscle reflexes during cold or touch.

As a baby boy grows in the womb, his testicles typically move from the lower belly into the scrotum, the pouch of skin below the penis. However, sometimes one or both testicles don't make this journey, a condition known as an undescended testicle. While it can happen to any baby boy, it's more common in those born prematurely.

Causes of Undescended Testicles

Doctors aren't entirely sure what causes undescended testicles, but they believe it may be related to a combination of factors, including:

  • Genetics

  • Maternal health conditions, such as diabetes or obesity

  • Exposure to certain chemicals, like pesticides

  • Smoking or alcohol consumption during pregnancy

Additionally, some health conditions, such as Down syndrome, may increase the likelihood of undescended testicles.

Symptoms and Diagnosis

The primary sign of an undescended testicle is the inability to see or feel the testicle in the scrotum. If both testicles are undescended, the scrotum may appear flat and smaller than expected. Your doctor will typically identify the issue during a routine check-up shortly after birth.

Undescended Testicles in Baby Boys: Causes, Symptoms, and Treatment Options

It's important to note that some boys may have retractile testicles, which can move up into the groin when cold or scared but return to the scrotum on their own. This is generally not a cause for concern.

Potential Complications

If left untreated, undescended testicles can lead to several complications, including:

  • Fertility problems, especially if both testicles are affected

  • Hernias

  • Increased risk of testicular injury

  • Slightly higher risk of testicular cancer

  • Testicular torsion, a painful condition where the spermatic cord becomes twisted

Treatment Options

In many cases, the testicle will descend on its own within the first few months of life. If it hasn't moved into the scrotum by 6 months of age, surgery is usually recommended. This procedure, called orchiopexy, is typically performed when the baby is between 6 and 12 months old to ensure the best possible outcomes.

During the surgery, the doctor will make a small incision in the groin or lower belly to locate the testicle, then gently move it into the scrotum and secure it in place with stitches. The procedure is usually done on an outpatient basis, and your child will be given medication to prevent pain and discomfort.

While hormone therapy is sometimes used to treat undescended testicles, it is less common and may not be as effective as surgery.

Conclusion

If your baby boy has an undescended testicle, it's essential to work closely with your pediatrician to monitor the situation and determine the best course of action. Early treatment, usually in the form of surgery, can help minimize the risk of complications and ensure the best possible outcomes for your child's future health and fertility.

For more information on undescended testicles and other common childhood health concerns, consult reputable sources such as the American Academy of Pediatrics, Mayo Clinic, or Urology Care Foundation.

The Bottom Line

Early surgical correction between 6-12 months is critical to prevent long-term complications including fertility problems and increased cancer risk. If you notice an empty scrotum or have concerns about your baby's development, Doctronic can provide quick answers and guidance on next steps.

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