Understanding Undescended Testicles

When a baby boy is born, both testicles are usually located in the scrotum — the sac of skin just below the penis. But in some cases, one or both testicles don’t move down into this position before birth. This condition, called an undescended testicle, or cryptorchidism, is one of the most common concerns parents bring to a pediatric urologist.

“It’s natural for parents to worry when something seems out of place,” says Abd-El-Rahman “A.R.” Abd-El-Barr, MD, a pediatric urologist at AdventHealth Tampa. “But with the right evaluation and timely care, most boys with an undescended testicle go on to develop normally and live healthy, active lives.”

What Is an Undescended Testicle

Before a baby is born, the testicles form inside the abdomen. In most cases, as the baby grows, the testicles gradually move down through a small tunnel in the lower belly, called the inguinal canal, into the scrotum. This usually happens during the final months of pregnancy.

When one or both testicles don’t complete this journey, it’s known as an undescended testicle. According to the Urology Care Foundation and the American Urological Association, the problem affects about 3% of newborn babies and up to 21% of premature babies.

In most cases, the undescended testes drop on their own within the first few months of life. If they haven’t descended after six months, you should bring your child to a pediatric urologist for an evaluation.

Sometimes, the testicle is felt higher up in the groin. In other cases, it’s located inside the abdomen and can’t be felt at all. “The position of the testicle helps us determine the best treatment approach,” Dr. Abd-El-Barr says.

Causes of an Undescended Testicle

What causes an undescended testicle isn’t always known. In some cases, it’s related to a mechanical issue as the fetus develops. In other cases, hormonal or genetic factors may play a role. Family history can also be a factor — boys whose fathers or brothers had an undescended testis are at slightly higher risk.

“It’s important for parents to know that this isn’t anyone’s fault,” Dr. Abd-El-Barr says. “It’s something that happens during development and can be successfully corrected in most cases.”

Undescended Testicle Symptoms

As a parent, you can usually tell if your newborn’s testicle hasn’t descended. The scrotum may look smaller, flatter or asymmetrical.

Your child’s pediatrician will also likely notice the condition during a routine exam. If they can’t feel the testicle, they may order imaging tests to determine where it’s located. Sometimes, an undescended testicle is confused with retractile testicles — testicles that move up and down between the scrotum and groin. Retractile testicles don’t require treatment, but undescended testes do.

The Importance of Early Treatment

If an undescended testis isn’t corrected, it can cause problems later in life, including:

• A greater likelihood of testicular torsion (twisting of the testicle)
• An increased risk of testicular cancer
• Reduced fertility
• Risk of trauma to the testicle

“Treating an undescended testicle early — ideally between 6 and 18 months of age — gives the best chance for normal development and fertility later,” Dr. Abd-El-Barr says. “It also lets us monitor that testicle more easily as the child grows.”

Treatment Options

In most cases, your child’s doctor will recommend undescended testicle surgery, called an orchiopexy. This procedure moves the testicle into the scrotum and secures it in place to prevent it from moving back up into the abdomen. The surgery is performed under general anesthesia, typically as an outpatient procedure.

When your child’s doctor can feel the testicle in the groin, they make a small incision during the surgery to gently reposition it. If they can’t feel the testicle, they may use a minimally invasive laparoscopic approach to locate and move it. Most children recover quickly from an orchiopexy and can return to normal activities within a few days.

“Parents are often surprised by how straightforward the procedure is and how quickly their child recovers from it,” Dr. Abd-El-Barr says. “Our goal is always to make sure the experience is as smooth and comfortable as possible for the whole family.”

Pediatric Urologic Care for Your Child’s Whole Health

At AdventHealth Tampa, families find more than advanced surgical expertise — they find a team that cares for each child’s body, mind and spirit. “We understand how stressful it can be for parents to hear their child may need surgery,” Dr. Abd-El-Barr says. “That’s why we take time to explain every step to ensure families feel informed and supported.”

Whether your child’s condition requires close observation or a minor procedure, our pediatric urology team offers personalized care in a calm, child-friendly environment.

To learn more or schedule a consultation, call Call813-756-1755 to connect with AdventHealth Medical Group Pediatric Urology at Tampa.

About Dr. A.R.

Abd-El-Rahman (A.R.) Abd-El-Barr, MD, is a board-certified pediatric urologist who is committed to providing compassionate and conscientious care to his patients with the help of a multidisciplinary team, to provide optimal outcomes.