Undescended Testicles
by Douglas J
Undescended testicles occur in about 0.5% of live births and boys with hypospadias are at a very slightly increased risk of having an undescended testicle. The rate of undescended testicles increases directly with prematurity, because testicular descent is one of the last things to occur in fetal life.
Testicles are usually fully descended into the scrotum at birth, and the old saw about "balls dropping" at puberty is nonsense. Any child who has an unpalpable (cannot be felt) testicle should be evaluated to locate it and verify that it is viable. Non-reversible changes in the testicle can occur as early as six months after birth, so time is of the essence in these cases. After two years of age, most undescended testicles will be compromised and non-functional. Undescended testicles are an increased risk factor for cancer, and the main reason for locating an undescended testicle to the scrotum is so it can be examined. It is important to remember that the increased risk of cancer is permanent and present for the normal testicle, even if an undescended testicle is removed. The surgery to locate a testicle in the scrotum is orchidopexy. Surgical removal of a testicle is orchiectomy.
All boys and men with an undescended testicle or born with a single testicle should be taught to self examine beginning at puberty. Testicular cancer is the leading carcinoma in the 15-25 year old male, and it is highly curable if detected early.
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