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Condition. Undescended testicle

By Editorial Team (A)
September 9, 2021
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As a male fetus develops, testicles migrate from the abdomen to the skin bag under the penis. The last is called the scrotum. If the testicle doesn’t move as intended, the person develops an undescended testicle (cryptorchidism) condition. In most cases, this abnormality affects only one testis. Nevertheless, in around one in ten persons with this diagnosis, both testicles are impacted.

An undescended testicle is a relatively rare condition. Despite this, it is common in boys that were born prematurely. Luckily, in most cases, an undescended testicle goes down into the correct position by itself. It occurs within the first few months of a baby’s life. If the testicle doesn’t relocate on its own, the use of surgery can help move it into the scrotum.

Undescended testicle causes

There is no specific cause of undescended testicle known these days. Instead, the combination of different factors may influence the activity of nerves, hormones and physical changes. They, in turn, impact the development of testicles.

Undescended testicle risk factors

There are three groups of factors that increase the risk of an undescended testicle in an infant. They are genetics, environmental and maternal health constituents. Overall, risk factors include:

  • premature birth
  • low birth weight
  • fetal conditions that interfere with the child’s growth (for example, abdominal wall defect or Down syndrome)
  • maternal smoking or secondhand smoke exposure during pregnancy
  • alcohol consumption by the mother during pregnancy
  • some pesticides exposure by parents
  • family history of cryptorchidism or other abnormalities of genital development

Cryptorchidism symptoms

Having an undescended testicle is characterized by not feeling it in the scrotum where it should be. The doctor usually detects this condition during a regular examination performed shortly after the infant’s birth. If the baby has an undescended testicle, it is good to discuss the schedule of further checkups with the healthcare provider.

Generally, the testicle migrates to the scrotum during prenatal development. However, suppose it fails to do so. In that case, the testis usually repositions to the proper location within the first few months of a boy’s life. If it didn’t happen till the fourth month, then the chance that the testicle will relocate by itself is tiny. Therefore, the treatment should be applied. It is better to treat an undescended testicle in infants. Fixing the situation while the boy is still a baby helps prevent complications later in life. They include conditions such as testicular cancer and infertility.

Another case of the improperly located testicle may occur in boys ageing from infants to pre-adolescents. In this situation, the testicle descended as it should do during prenatal development. Nonetheless, later in life, the testis may “disappear” from the scrotum. There are two explanations for this event:

  • An ascending testicle, also called acquired undescended testicle, is a condition when the testicle moves back from the scrotum to the groin. 
  • A retractile testicle is a movement of the testicle back and forth between the scrotum and groin. A condition like this isn’t abnormal. It happens due to a muscle reflex in the scrotum. The doctor can easily relocate the testicle to its proper location by hand. 

Complications

The correct position of testicles is essential for them to function normally. The scrotum is an ideal location for these organs. It provides a slightly cooler environment comparable to the overall body temperature. Therefore, positioning of the testicle in an abnormal place can lead to the following complications:

  • fertility problems
  • testicular cancer
  • testicular torsion (a twisting of the spermatic cord which cuts off the blood to the testicle; a painful condition which, if untreated, can result in a loss of the testicle)
  • inguinal hernia (part of the intestine bulge into the groin)
  • trauma (when the testicle locates in the groin, it can be injured by the pubic bone) 

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