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Pediatric undescended testes (cryptorchidism - UDT)

Pediatric undescended testes (UDT) – also known as cryptorchidism – means that a testicle hasn’t moved into its proper position in the scrotum before birth.

Overview

What are pediatric undescended testes (cryptorchidism - UDT)?

The testicles are formed in the abdomen before your baby is born. While the baby is developing, the testicles follow a pathway from the abdomen through the groin and into the scrotum.  

In up to 5% of boys, the testicle does not complete this journey and this results in a testicle that is not in the scrotum and is located somewhere along this path, possibly still in the abdomen.

Signs and Symptoms

What are the signs and symptoms of pediatric undescended testes (cryptorchidism - UDT)?

  • Not seeing or feeling a testicle where you would expect it to be in the scrotum

  • Swollen lymph node (small, bean-shaped gland) in the groin

Diagnosis

How are pediatric undescended testes (cryptorchidism - UDT) diagnosed?

Physical exam - An undescended testicle (UDT) is usually detected by the parents or your pediatrician as an empty scrotum on exam. Your child's provider will likely attempt to determine whether they can feel the testicle in the groin canal. If not, it is possible that the testicle is still in the abdomen.   

An ultrasound may be helpful in finding the testicle that cannot be felt.

Treatment

How are pediatric undescended testes (cryptorchidism - UDT) treated?

Surgery (orchiopexy) is required to bring the testicle to its normal location in the scrotum for three reasons. 

  1. First, if that the testis in the abdomen it is subject to a higher body temperature which results in decreased sperm production. 

  2. Secondly, if the testis in the groin it is more susceptible to trauma. 

  3. Lastly, if the testis is in the abdomen it has a 40% higher risk of developing cancer. 

For best results, the surgery should be performed prior to your child turn 1 year of age. Depending on where the testicle is, this may be done with a single surgery through an incision in the groin or may require 2 or 3 operations including an exploration of the abdomen to find the testicle. Eventually, the testicle will be brought down and sutured to the scrotum - a procedure called an “orchidopexy.” 

There is a higher chance of developing testicular cancer in patients with a history of an undescended testicle. Therefore, routine testicular self-exam should begin when the patient transitions through puberty and into adulthood.

Doctors and Providers