Undescended Testes

During pregnancy the testes form inside the abdomen and gradually move down into the scrotum before birth. In some boys one or both testes have not completed this journey and sit in the groin or higher, so the scrotum looks small or empty on that side.

Undescended testes are more common in boys born early. Some testes will come down on their own in the first few months of life, but if a testis has not descended by around six months of age it is unlikely to do so. This is different from a retractile testis, which moves up and down freely and usually needs no treatment.

The scrotum keeps the testes slightly cooler than the rest of the body, which is important for their normal development. A testis that stays in the groin is warmer and may not develop as well, which can affect fertility later in life. Bringing the testis down also makes it easier to examine as your son grows, and reduces the risk of twisting (torsion) or injury.

For these reasons, surgery is generally recommended between around six and eighteen months of age. If an undescended testis is found later in childhood, surgery is still worthwhile and is arranged once the diagnosis is made.

The operation is called an orchidopexy and is performed under a general anaesthetic as day surgery. A small incision is made in the groin crease to find the testis and free it from the surrounding tissue so that it can reach the scrotum without tension. A second small incision in the scrotum allows the testis to be placed in a pocket and held there while it heals.

If the testis cannot be felt in the groin, a keyhole (laparoscopic) procedure is used to locate it inside the abdomen. Occasionally the operation is done in two stages a few months apart. All wounds are closed with dissolving stitches.

Most boys are comfortable with regular paracetamol or ibuprofen for a few days. Bruising and swelling of the scrotum and groin are normal and gradually settle over a few weeks.

Keep the wounds clean and dry for the first couple of days, then bathing is fine. Avoid straddle toys, bikes and rough play for about two weeks so the testis is not disturbed while it settles into its new position.

Contact the team if there is fever, the wounds become red or leak, or there is severe pain or swelling. Your child's surgeon will review the position and size of the testis at follow-up, and a check is usually offered again around puberty.