Blog Post

Undescended Testis in children (Cryptorchidism): Diagnosis, Timing, and Treatment in Children

January 13, 2026 Uncategorized by blogcreater

Being told that your baby’s testicle hasn’t reached its proper place — and wondering whether it will correct itself or need surgery.
For many parents, this uncertainty brings anxiety, confusion, and fear about long-term health.

Undescended testis is one of the most common conditions seen in infant boys — and when managed correctly and on time, outcomes are excellent.

Understanding Undescended Testis

During fetal development, the testis forms inside the abdomen and gradually moves down into the scrotum before birth.

About 3% of newborn boys are born with a testis that has not fully descended.

Most descend naturally within the first 6 months
A smaller number between 6–12 months
After one year of age, the incidence drops to around 1%

Undescended testis refers to a condition where one or both testes are not located in the scrotum beyond the expected age.

Not All “High” Testes Are the Same

In some children, the testis may move up and down — appearing in the scrotum at times and retreating into the groin at others. This is called a retractile (shy) testis.

A retractile testis is not the same as a true undescended testis
It usually requires observation and follow-up, not immediate surgery

A true undescended testis, however, does not stay in the scrotum and needs medical attention.

Where Can the Testis Be?

When a testis cannot be felt in the scrotum, several possibilities exist:

Stopped midway in the inguinal canal (true undescended testis)
Located in an abnormal position (ectopic testis)
Remaining inside the abdomen (intra-abdominal testis)
Under-developed or atrophic
Rarely, completely absent due to prenatal loss of blood supply (vanishing testis)

How Is Undescended Testis Diagnosed?

In most children, a careful clinical examination by a pediatric urologist is enough to make the diagnosis.

About 20% of testes are non-palpable, meaning they cannot be felt on physical examination.

In these cases:

Ultrasound or MRI usually does not add significant value
Laparoscopy is the preferred method for both diagnosis and treatment

Laparoscopy involves inserting a tiny camera through the belly button to locate the testis accurately within the abdomen.

Why Early Treatment Matters

If left untreated, an undescended testis can lead to long-term problems, including:

Reduced fertility later in life
Increased risk of testicular cancer
Higher chance of testicular torsion
Psychological and cosmetic concerns due to an empty scrotum

Early treatment significantly reduces these risks and protects future testicular function.

When Should Surgery Be Done?

The ideal age for surgical correction is between 6 and 12 months.

If the child also has an inguinal hernia, surgery should be performed earlier, without waiting.

The Gold-Standard Treatment

The definitive treatment for undescended testis is orchiopexy.

During the procedure:

A small incision is made in the groin
The testis is gently freed from surrounding tissues
Any associated hernia sac is repaired
The testis is placed securely in the scrotum and fixed in position

This also helps prevent future torsion.

Hormonal therapy may be tried in selected cases, but its success rate in true undescended testis is very low. Surgery performed by an experienced pediatric urologist remains the most reliable and effective treatment.