In most cases, the testicles (or testes) descend into the scrotal sac during foetal development. In 3% of newborn boys, the testes may not have descended at birth, but could do so over the first 6 months of life. If they haven’t done so, a consultation with a specialist paediatric urologist is advisable.
Undescended testes: What happens when I see a paediatric urologist?
When you make an appointment with a paediatric urologist, they will then examine your baby and check the position of the testes.
If the testes do not descend to the correct position easily, but they are easy to feel in the groin, then an orchidopexy procedure will be recommended at around 9 months of age. An orchidopexy is done as a day-case procedure, meaning your child will not need to stay in hospital, and will be able to return home after the procedure.
The procedure releases the testicle and fixes it in a pouch in the scrotal sac. There are a number of reasons why surgery may be necessary at this age:
- According to research, the germ cells in the testes may not mature at the normal rate, which may cause problems with fertility later in life.
- Undescended testes carry a higher risk of twisting. If the testis becomes twisted, there is a chance that it may have to be removed if the twist is not corrected in time.
- Undescended testes carry a higher risk of testicular cancer later in adulthood. Operating to descend the testicle reduces, but does not remove this risk later in life.
If the testicle can’t be felt in the groin, then surgery may also be necessary in the form of a laparoscopy via the belly button, to initially locate the testicle.
Other investigations such as ultrasound are not usually helpful as laparoscopy will be required anyway. The testicle may be 'retractile' and may pop in and out of the scrotum. This is a natural reflex and only requires annual observation initially.
If you are concerned about undescended testes in your child, make an appointment with a paediatric urologist.