Testicular Maldescent
What is Testicular Maldescent?
Testicular maldescent, also known as an undescended testicle or cryptorchidism, occurs when one or both testicles fail to move down into the scrotum before birth. Normally, the testicles form in the abdomen and descend into the scrotum during foetal development. When this process is incomplete, the testicle may remain in the abdomen, the groin or another point along the normal pathway of descent.
It is one of the most common congenital conditions seen in male infants and may affect one or both testicles. Early identification and timely treatment help reduce the risk of long-term complications and support normal testicular development.
What causes testicular maldescent?
Several factors may influence whether a testicle descends normally. Premature birth increases the likelihood of an undescended testicle because the descent often occurs in the final months of pregnancy. Hormonal or genetic factors may affect the development or function of the structures involved in testicular descent.
Abnormalities in the testicle, spermatic cord or inguinal canal may interrupt or delay the descent. A family history of undescended testicles may also increase risk. In some cases, no specific cause is identified.
Who is affected?
Testicular maldescent primarily affects newborn boys but can be identified later in infancy or early childhood if not detected at birth. It may involve one testicle or, less commonly, both.
Boys born prematurely or with low birth weight have a higher chance of being affected. Children with certain genetic or hormonal conditions may also be at increased risk.
Common symptoms
The most common sign is an empty or underdeveloped scrotum on one or both sides. The testicle may not be felt in the scrotum during examination, and sometimes it may be located in the groin or partway along its normal path of descent.
Occasionally, a firm area or swelling may be noticed in the groin. Discomfort or pain is rare but may occur if the testicle becomes trapped or twisted. Many cases are detected during routine newborn or infant examinations.
What are the possible complications of testicular maldescent?
If the condition is not corrected, several complications can occur.
How is testicular maldescent diagnosed?
Diagnosis is usually made through physical examination. A clinician will examine the scrotum and groin to locate the testicle and assess its position.
Imaging such as ultrasound or MRI may be used if the testicle is not easily felt or appears to be in an unusual location.
A detailed medical history, including birth details, gestational age and family history, can help guide assessment and treatment planning.
Preventing complications
Although testicular maldescent cannot be prevented, early evaluation and timely intervention greatly reduce the risks of fertility problems, cancer and hernias. Routine newborn and childhood examinations are important for early detection.
How do you treat testicular maldescent?
Treatment depends on the age of the child and whether the testicle descends naturally.
Observation is appropriate for many infants in the first few months of life, as some testicles descend on their own. Regular follow up during this period is recommended.
Hormonal therapy may be considered in select cases to stimulate descent, although this is used less commonly.
Surgical correction, known as orchiopexy, is the most effective and widely recommended treatment. The procedure brings the testicle into the scrotum and secures it in place. Surgery is usually performed between six months and one year of age to improve long term outcomes and reduce the risk of complications.
When should you see a doctor?
You should seek medical review if your baby's testicle is not felt in the scrotum, if the scrotum appears underdeveloped or asymmetric, or if there are concerns about a mass or swelling in the groin.
Medical assessment is also recommended following orchiopexy to ensure the testicle remains in the correct position. Older boys or adolescents should seek review if they notice changes in testicular position, discomfort or concerns about fertility.
If you have concerns about testicular maldescent in your child, our team is here to help. We can provide assessment, advice and a personalised treatment plan to support healthy development and long-term wellbeing.
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