An Expert Pediatric Urologist Discusses Undescended Testis

People visiting urologist to check out undescended testis.

By Wolfgang Cerwinka, M.D.

A testicle outside its normal location in the scrotal sac is called an undescended testis. Undescended testes are relatively common and are found in 1 of 100 boys. This condition may be regarded as a failure of a testicle to descend into the scrotal sac, which normally occurs before birth.

Keep reading to learn more about this urological condition.

Who Is Likely to Get Undescended Testis?

Undescended testes are therefore more commonly found in prematurely-born boys. Studies have shown that undescended testes may descend spontaneously during the first 6 months of life only. Boys with undescended testes born early should be given extra time for spontaneous descent. The longer a testes remains undescended the higher the likelihood of damage (less sperm production) and testicular cancer.

Surgery for Undescended Testis

These are the two main reasons why boys should undergo surgery between 6 and 12 months of life. Although surgery for undescended testes, called orchiopexy, is one of the most common surgeries in pediatric urology, we rarely encounter the consequences (infertility, testicular cancer) because these are conditions typically occurring during adult life.

Undescended Testis at Georgia Urology

However, the reason for me to write this blog is a recent patient encounter that reinforced for me the importance of proper diagnosis and treatment of an undescended testis. An 18-year old male presented for a life-long history of an undescended testis; in fact, the right testis was never able to be felt on physical exam (non-palpable testis).

There are several reasons for a testicle to be non-palpable, one of them being the testicle is located inside the abdomen. No imaging study such as ultrasound or MRI is accurate enough to visualize an undescended testis. Instead, the recommended management is to perform a procedure where a small camera is introduced into the abdomen (diagnostic laparoscopy) to firstly identify a testicle if present and secondly to move the testicle into the scrotal sac.

During his procedure, a small testicle was seen inside the abdomen and, anticipating poor function, removed. A pathology report was issued a few days after surgery and showed that most of the removed testicle was occupied with seminoma, a malignant type of testicular cancer. Fortunately, for the patient, the testicular cancer was confined to the testicle, and the patient elected to be managed with future imaging studies only, no chemotherapy, no radiation treatment. Imagine if no surgery had been performed and cancer had grown and spread unnoticed inside the abdomen.

If you have any more questions about undescended testis, contact the experts at Georgia Urology.