Undescended Testis
What is Undescended Testis?
Undescended testis – also known as cryptorchidism – is a condition which causes one or both testicles not to be present in the normal position inside the scrotum. It is estimated that 1 in 25 newborns has undescended testis at birth. Some of these babies will be normal as the testis can still migrate down to the scrotum up to the age of three months. In general, only one testicle is affected (undescended testicle), although in around 10 percent of cases both testicles are undescended.
What is cryptorchidism?
An undescended testicle, medically known as cryptorchidism, is a common condition in young male children where one of the testicles has not moved into its usual position in the scrotum. It can occur with one (unilateral cryptorchidism) or both (bilateral cryptorchidism) testes. It is a problem that is thought to affect approximately 4% of baby boys, although in most cases the testicle(s) will descend of its own accord in the first six months after birth. An undescended testicle may be in one of a number of places:
What causes undescended testis?
The cause of undescended testis is not completely known. For some reason there is a mistake in the process which is moving the testis from the tummy, where the testis is developed, to the scrotum. This migration should occur in the last two months of foetal life but it can also happen in the first three months of postnatal life as mentioned above.
It is thought that there may be several factors - such as genetics, environmental factors, and maternal health - which could disrupt hormones and nerve activity, impacting on the development and migration of the testicles.
Risk factors associated with an undescended testicle in newborn boys include: premature birth; a low birth weight; foetal conditions which can restrict growth, like a defect in the abdominal wall or Down Syndrome; use of cigarette smoking or alcohol during pregnancy.
How to recognise an undescended testis?
The main presentation of an undescended testis is an empty scrotum with a non-palpable testicle. This condition is usually identified shortly after birth. Under routine newborn examinations, if the testis has not descended into the scrotum by the age of three months, it is unlikely to do so on its own and surgical intervention (orchidopexy) becomes necessary.
Mr. C.K. Sinha specialises in the diagnosis and surgical treatment of undescended testis. Early surgical correction is essential—not only to improve future fertility potential but also to allow easier monitoring for testicular abnormalities, such as lumps or testicular cancer. Additionally, correction ensures a normal appearance of the scrotum, which can be important for psychological well-being.
Mr. Sinha provides expert and compassionate care for children with this condition, ensuring both parents and children are well-supported throughout the treatment journey.
Treatment options for undescended testis
The surgery to correct undescended testis is called orchidopexy. It requires one small incision in the groin and a second one in the scrotum. This operation is usually performed as a day case, and your child will be back to his normal in a couple of days.
Key-hole surgery (laparoscopy), which uses a tiny camera placed through the belly button, is needed when the testicle in non-palpable in the groin. It is possible, in this case, that the testicle is either inside the abdomen or it was never developed.
Surgery involves the careful manipulation of the testicle to separate some congenital adhesions that are keeping the testis away from the scrotum. Then a tunnel and a pouch are created to bring the testis in the final position inside the scrotum where the testis is stitched in place.
For cases in which the testicle is abnormal, or not developed, the recommendation is to remove the nibble or small residual testis to avoid problems, such as cancer, in the adult life.
An inguinal hernia or hydrocele may be associated with the undescended testis, and they can be repaired during the same operation.
Following the procedure, the testicle will be monitored for a few years to ensure that it is developing normally, and it remains in place.
"Mr C.K. Sinha took excellent care of our son, who underwent surgery for his testicle. From the very first consultation through to the surgery and aftercare, he was exceptional—highly professional, calm, and genuinely caring. He made us feel completely at ease and confident throughout the process. We truly felt our son was in the best possible hands. We would wholeheartedly recommend him."
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MR CK SHINA
Consultant Paediatric Urologist & Paediatric Surgeon