An undescended testicle (Cryptorchidism)occurs in the womb, and although it is rare it most often affects premature infants. One or both testicles may not be visible, but not because of an abnormality. An over responsive muscle pulls them taut and away from the scrotum. The condition is known as retractile testes.
The testicles enlarge at puberty and usually descend without medical intervention. However, in most cases the testicles naturally descend within nine months after birth. When the testicle leaves the scrotum after descending, the condition is known as an ascending testicle. It cannot be corrected by moving it back into place. The cause of an undescended testicle is not fully understood, but it may be genetic, environmental or hormone related.
There are no underlying symptoms of an undescended testicle. One or both testicles are absent from the scrotum. In some cases, one or more testicles cannot be felt during a physical examination.
A male’s testicles form in the abdomen before birth. In the last few months of development before birth, the testicles descend into the scrotum, where they remain for life. In some cases, however, one or both testicles do not descend.
The reason for this is not known, although there is considerable evidence that there are genetic factors at play. An undescended testicle may also be caused by maternal health and/or other environmental factors. Any of these might disrupt the hormones, physical changes and nerve activity that can influence the normal development of the testicles.
There is also evidence that physical trauma to the abdomen either before birth or after birth and before the testicles have descended can cause failure of the testicles to develop normally. Also, if the canal that the testicles pass through on their way to the scrotum is too loose or too narrow, either case can cause them to fail to descend.
Unfortunately, in these cases, they will probably not descend on their own. Surgery is normally required to get the testicles to descend into the scrotum. It is important not to confuse this with retracted testicles, which is a temporary condition that usually solves itself when the retractile testicle returns to a normal position in the scrotum on its own.
In the majority of cases, treatment is not required. However, if they do not naturally descend at puberty, the condition is considered abnormal. Surgical intervention is necessary to correct the abnormality. Even more rarely the testicle(s) never formed. Imaging will likely take place to determine their location as well as any irregularities.
The risk of testicular cancer is higher in those with an undescended testicle, even after surgical correction. Both testicles are at greater risk. It is important to have regular exams to detect early testicular cancer. Also, an undescended testicle can reduce fertility, especially if it goes uncorrected beyond the recommended time.
There are several risk factors that might lead to undescended testicles, any of which could be avoided in order to prevent the situation from happening.
These include, but are not limited to, low birth weight, premature birth, family history or undescended testicles and other problems with genital development, fetal conditions that restrict growth such as Down syndrome, or a defect in the abdominal wall, alcohol use during pregnancy, smoking by the mother during pregnancy, exposure to secondhand smoke, and exposure to pesticides by parents.