What are the causes and treatment options for undescended testicles?

Symptom Database

Undescended testicles, also known as cryptorchidism or testicular maldescent, is a condition where one or both testicles fail to descend into the scrotum. This condition is relatively common in newborns, affecting around 3-5% of full-term male infants and up to 30% of premature infants. While the testicles usually descend on their own within the first few months of life, some cases require medical intervention. In this article, we will explore the causes and treatment options for undescended testicles, as well as the potential complications associated with this condition.

Causes of Undescended Testicles

The exact cause of undescended testicles is not fully understood, but several factors may contribute to this condition:

  • Hormonal factors: Hormones play a crucial role in the development of the male reproductive system. Insufficient production or action of certain hormones can hinder the descent of the testicles.
  • Anatomical factors: Abnormalities in the structure of the testicles, scrotum, or inguinal canal can impede the natural descent of the testicles.
  • Premature birth: Premature infants are more likely to have undescended testicles due to the immaturity of their reproductive system.
  • Familial predisposition: There is evidence to suggest that undescended testicles may have a genetic component, as the condition tends to run in families.

Treatment Options for Undescended Testicles

The treatment for undescended testicles depends on various factors, including the age of the individual and the severity of the condition. Here are the main treatment options:

Watchful Waiting

In some cases, especially when the testicles are expected to descend on their own, a period of watchful waiting may be recommended. Regular check-ups with a healthcare provider will be scheduled to monitor the progress of the testicles’ descent. If the testicles do not descend within the expected timeframe, further intervention may be necessary.

Hormone Therapy

Hormone therapy involves the administration of hormones, such as human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone (GnRH), to stimulate testicular descent. This treatment option is typically used in infants with mild cases of undescended testicles. However, hormone therapy is not always effective and may require multiple courses of treatment.


Surgical intervention is often the most effective treatment for undescended testicles. The two main surgical procedures used to correct this condition are:

  • Orchiopexy: This procedure involves surgically moving the undescended testicle into the scrotum and securing it in place. Orchiopexy is usually performed between the ages of 6 and 18 months.
  • Orchiectomy: In some cases, if the testicle is severely undescended or if there are concerns about its health, removal of the testicle may be necessary. This procedure is called orchiectomy.

Both orchiopexy and orchiectomy are typically performed under general anesthesia, and the specific approach may vary depending on the individual case.

Complications of Undescended Testicles

If left untreated, undescended testicles can lead to various complications, including:

  • Infertility: Undescended testicles can impair sperm production and function, potentially leading to infertility in adulthood.
  • Testicular cancer: Men with a history of undescended testicles have an increased risk of developing testicular cancer later in life. However, the risk is significantly reduced if the condition is treated early.
  • Torsion: Undescended testicles are more prone to testicular torsion, a condition where the testicle twists on its own blood supply. Testicular torsion is a medical emergency that requires immediate surgical intervention to prevent testicular damage.

Undescended Testicles in Infants vs. Adults

Undescended testicles are most commonly diagnosed in infancy, but they can also occur in adults. The treatment approach may differ depending on the age of the individual:

Undescended Testicles in Infants

In infants, the first-line treatment for undescended testicles is often watchful waiting or hormone therapy. Surgery is typically reserved for cases where the testicles do not descend on their own or if hormone therapy is ineffective.

Undescended Testicles in Adults

In adults, the treatment for undescended testicles is almost always surgical. Orchiopexy is the preferred procedure to correct the condition and restore normal testicular function. However, the success rate of surgery may be lower in adults compared to infants.

Symptoms of Undescended Testicles

Undescended testicles can usually be identified through a physical examination. However, in some cases, the condition may not be immediately apparent. Common symptoms of undescended testicles include:

  • Empty scrotum: The scrotum may appear smaller or underdeveloped on the affected side.
  • Palpable testicle: The testicle may be felt in the inguinal canal or abdomen rather than in the scrotum.
  • Asymmetrical scrotum: The scrotum may appear uneven or asymmetrical due to the absence of a descended testicle.

If you suspect that you or your child may have undescended testicles, it is important to consult a healthcare professional for a proper diagnosis and appropriate treatment.

In conclusion, undescended testicles are a common condition that can be effectively treated. Early intervention is crucial to prevent potential complications such as infertility and testicular cancer. By understanding the causes, treatment options, and potential complications associated with undescended testicles, individuals and parents can make informed decisions regarding their healthcare.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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