When the baby is being formed, the testes are initially made up in the abdomen, near the kidneys. They then go through a process called testicular descent whereby the testes descend down through the abdomen and into the scrotum. Isn’t nature amazing?. However, sometimes the testes fail to descend normally and can be halted at any point along the way, hence the term undescended testes. Most of the time they are halted outside the abdominal cavity and are “stuck” in the groin.
Sometimes though they can be halted inside the abdominal cavity.
Most children do not complain about having undescended testes. It is normally diagnosed at the time of birth or at the 6 week check. Some parents will also notice that the testicle would appear missing when changing the child’s nappy or bath time. Both testes should be present at the base of the scrotum by 3 months of age and if they are not, they will require surgery. Occasionally children will develop an ascending testes, this occurs in older children between the ages of 7 – 11 years old of which the testicle was in a normal position then moves out of the scrotum. Once again, these young boys do not generally notice this change but are spotted by their parents when they are being showered or bathed.
In reality, we do not really understand as to why children develop undescended testes. It is a very common condition affecting 1 in 100 boys. If a boy has undescended testes, he increases the risk for his relatives having undescended testes, both the siblings and his own children. However, the vast majority cases are spontaneous and there is no distinct cause or risk factor.
Without a doubt, the most useful and successful treatment for undescended testes is an Orchidopexy. This consists of an operation which brings the testicle down into the base of the scrotum and fixes it into that position.
If the testes are palpable and it can be felt during clinical examination, the operation will consist of an incision in the groin and the testis is freed up. Frequently there is a small hernia present which is repaired at the same time. The testes are brought down into the scrotum, a small incision is made and is placed into a small pouch.
If the testicle is not palpable, a keyhole procedure will occur in which a camera is placed into the abdomen. If the testis is present in a reasonable shape, a two stage procedure will be required in order to bring it down into the scrotum.
A vast majority will be able to go home the same day and do extremely well.