Undescended testicle

Alternative names:

cryptorchidism; empty scrotum; monorchism; scrotum - empty

Definition:

Failure of the testicle to move from the abdominal cavity to the scrotum.

Causes, incidence, and risk factors:

The testicles develop before birth in the abdominal cavity. Normally, they descend into the scrotum before birth. Undescended testicle occurs when the testicle fails to move into the scrotum prior to birth.

Undescended testicles are fairly common in premature infants, and occur in about 3 to 4% of full-term infants. In these cases, the testicles typically descend by 3 months of age.

Once a testicle has been discovered in the scrotum, it is generally considered descended even if it is temporarily retracted on a later examination. Sometimes a condition (referred to as migratory testes) will develop, in which the examiner can sometimes locate the testicles and sometimes not. This occurs because of the strength of the muscular reflex (cremasteric reflex) that retracts the testicles and the small mass of the testicles before puberty. In this instance, the testicles descend at puberty.

Testicles that do not descend by one year of age should be carefully evaluated. Abdominal ultrasound may help determine the presence of testicular material. Recent studies suggest that definitive surgery should be accomplished by three years of age to confirm diagnosis and to lessen the likelihood of developing testicular cancer later in life.