Usually just one testicle is affected, but in about 10% of cases both testicles are undescended. The testicle may lie in the groin or in severe cases within the abdomen. The undescended testicle moves into the proper position on its own, within the first 3 months of life. If your son has an undescended testicle that doesn’t correct itself by 3 months of age, surgery will be needed.

When to see a doctor ?

           Not seeing or feeling a testicle where you would expect it to be in the scrotum is the main sign of an undescended testicle. In such a case it is advisable to meet a pediatric surgeon.

           Treating an undescended testicle when your son is still a baby might lower the risk of complications later in life, such as infertility and testicular cancer.

            Older boys — from infants to pre-adolescent boys — who have normally descended testicles at birth might appear to be “missing” a testicle later. This condition might indicate:

• A retractile testicle, which moves back and forth between the scrotum and the groin and might be easily guided by hand into the scrotum during a physical exam. This is not abnormal and is due to a muscle reflex in the scrotum and it doesn’t need any surgery.
• An ascending testicle, or acquired undescended testicle, that has “returned” to the groin and can’t be easily guided by hand into the scrotum.

What are the causes of UDT ?

The exact cause of an undescended testicle isn’t known. A combination of genetics, maternal health and other environmental factors might disrupt the hormones, physical changes and nerve activity that influence the development of the testicles.

What are the risk factors for UDT ?

• Low birth weight
• Premature birth
• Family history of UDT
• Genetic abnormality
• Alcohol use by the mother during pregnancy
• Cigarette smoking by the mother or exposure to secondhand smoke
• Parents’ exposure to some pesticides

What are the complications of UDT ?

                In order for testes to develop and function normally, they need to be slightly cooler than normal body temperature. The scrotum provides this cooler environment. Complications of a testicle not being located where it is supposed to be include:

• Testicular cancer. Men who’ve had an undescended testicle have an increased risk of testicular cancer. The risk is greater for UDT located in the abdomen than in the groin, and when both testicles are affected. Surgically correcting an undescended testicle might decrease, but not eliminate, the risk of future testicular cancer.
• Fertility problems. Low sperm counts, poor sperm quality and decreased fertility are more likely to occur among men who’ve had an UDT.
• Testicular torsion. It is the twisting of the spermatic cord, which contains blood vessels, nerves and the tube that carries semen from the testicle to the penis. This painful condition cuts off blood to the testicle and requires urgent surgery.

Testicular torsion occurs 10 times more often in UDT than in normal testicles.

• Trauma. If a testicle is located in the groin, it might be damaged from pressure against the pubic bone.
• Inguinal hernia. If the opening between the abdomen and the inguinal canal is too loose, a portion of the intestines can push into the groin.
• Emotional stress

How is UDT diagnosed ?

     UDT is easily diagnosed by clinical examination by the pediatric surgeon. Sometimes, ulrasound , CT scan or MRI may be needed for diagnosis.

How is UDT treated ?

            Treatment will depend on your child’s symptoms, age, and general health. In many cases, the testes descend on their own into the scrotum by age 3 months. In other cases surgery (Orchidopexy) is the treatment modality. The ideal time for surgery is 6 months to 1 year of age. If the testicle is felt by the surgeon then the surgery is open orchidopexy. In case the testicle is within the abdomen, laparoscopic orchidopexy is the treatment of choice.

FAQ regarding UDT ?

• Is surgery always needed ?

              If the testicle hasn’t descended on its own by 3 months of age, then surgery is the only option.

• Ideal time for surgery ?

              6 months to 1 year of age

Key Words : Undescended Testis | UDT | Orchidopexy