Undescended Testicle

Before a baby is born, testicles start up by the kidneys during development in the womb and slowly make their way down to the scrotum (the sack of skin beneath the penis) through an opening in the groin called the inguinal canal. Sometimes, the testicles do not completely descend on their own. When this happens they can be anywhere from the abdomen, to the inguinal canal, or the upper scrotum.

Normally we give the testicles time to descend on their own. Typically 70 percent of testicles will descend by 6 months, 85% by 9 months, and 90% by 1 year.  If the testicle has not descended by a year it is very unlikely it will. In that scenario we would recommend surgical correction.  

Surgery is needed to bring the testicle down to the scrotum because the scrotum is the correct environment for the testicle to develop.  When the testicle is higher up, it is in a warmer temperature which is not ideal for normal growth.  The testicle also needs to be in the scrotum so the patient can perform testicular exams when he is older to notice whether there are any abnormalities that need to be further assessed.

This surgery is called an orchidopexy and is done under general anesthesia.  This is a day surgery as the patient will go home the same day.  There are a few different possibilities on the specifics of the surgery.

1. If the testicle is felt during exam we will make an incision in the inguinal canal to find the testicle followed by an incision in the scrotum to bring the testicle down.  

2. If the testicle is not felt on exam we will need to put a camera in through the patient’s belly button to look for the testicle in the abdomen.  

   • Should the testicle be found in the abdomen, and it is low enough, we will bring it down that day.  

   • If the testicle is found very high up in the abdomen, we will need to perform the surgery in stages. First the surgery requires cutting a specific blood supply that is tethering the testicle high up.  Then 6 months later we will bring the testicle down completely

   • If the testicle is not found or is found to be very abnormal we will discuss the possibility of removing the testicle during surgery.  This will be a conversation the surgeon and parents will have before any decision is made.