Undescended testes

I have 3 sons, ages 7, 5, and 2. The testicles of my 7-yr. old have not decended into the scrotum. Upon examination from our G.P., he has only been able to find one testicle on the 7-yr. old. My 5-yr. old also has only one testicle that has descended. The other is still up in the body. My questions are:

  1. Should I be concerned for both boys, especially the 7-yr. old, in getting the testicle(s) surgically brought down into his scrotum?
  2. Is there a way to verify if he, in fact, only has one testicle?
  3. Is this a common occurrence?

My G.P. doesn't seem too concerned.

Thanks in advance, David


Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

Dear David,

Testicles originate in the abdomen while the fetus is developing. As the fetus grows, the testes descend into the scrotum. Male infants born at term should have both testicles descended. Preterm infants often do not have the testicles fully descended, however, they do so by the time the infant is at the age of when he would have normally been born.

Many males have what are called retractile testes. This is a benign condition in which the testes tend to lie high in the scrotum such that the scrotum may look empty especially when it is cold. Differentiating this condition from undescended testes is important and done by examination. The child is placed in a warm room and the doctor's examination is done with the child in a squatting position. The testes are then manually brought down into the normal position. This should not cause pain, and the testes then go back to their original high position when let go.

If the testes cannot be demonstrated to be placed into the correct position manually, undescended testicles are then suspected. An ultrasound is generally the next step to see where the testicle lies or if it is non-existant.

There are two major concerns about undescended testes. Studies show that undescended testes have significant loss for fertility if not surgically brought down by the age of 2 years, and many pediatric surgeons believe that 2 years may even be too late. In addition, males whose undescended testes remain in the abdomen have a 20-40% greater risk of testicular cancer.

David, the first step for you to do is to confirm whether your sons' examination is one of retractile or undescended testes. If there is any doubt, an ultrasound can be quite helpful. If the testes are truly undescended, they must be either surgically brought down or removed.

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