Undescended Testicle: Exams And Tests

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Exams and Tests

Usually the doctor will notice an undescended testicle during a physical exam as part of a newborn or routine well-baby checkup. The doctor will ask questions about your baby's medical history that can help diagnose an undescended testicle. If your baby's doctor suspects this is the problem, he or she will usually refer your baby to a specialist, such as a pediatric surgeon or a pediatric urologist.

Your baby's doctor will conduct a physical exam to see whether the testicle can be felt (palpable). If it is palpable but has not descended into the scrotum, your baby likely will be examined again in 3 to 6 months. Undescended testicles usually descend on their own sometime within the first year, usually within the first 3 months.

If the undescended testicle cannot be felt (nonpalpable) during a physical exam, further testing will be needed to determine whether the condition is:

• An ectopic testicle. The testicle is in an abnormal position in the groin area.
• A retractile testicle. In this case, the testicle has fully descended but is sometimes pulled up out of the scrotum by the muscle that is attached to it.
• An absent or malformed testicle. This can be caused by a problem with the development of the testicle during pregnancy.
• Hypospadias. This is a common birth defect where the urethra does not extend to the tip of the penis. Instead, the opening of the urethra is located somewhere along the underside of the penis. In many cases of hypospadias, the testicles do not descend.

The process to identify the type of undescended testicle or rule out other similar conditions may include:

• Hormone testing, using a blood sample, to determine whether the testicles are absent (anorchia). But the test results sometimes do not clearly indicate whether the testicles are missing.
• Exploratory surgery, to verify the presence of one or both testicles and to evaluate their condition. The doctor may use laparoscopy to look inside the abdomen if a testicle is not felt during a physical exam. During laparoscopy, the surgeon puts a tiny lighted instrument into the baby’s belly through a small cut below the belly button.
• Medical imaging tests, such as ultrasound, MRI, or CT scan, to help locate an undescended testicle. But these tests are not effective enough to replace physical exams, hormone testing, and laparoscopy. Also, small children have to be sedated for some imaging tests, which makes these tests less likely to be used. Imaging tests are used more often for older boys, teens, and adult men than for infants and young boys.

What to think about

The risk for testicular cancer is more than 20 times greater in males who have ever had an undescended testicle than in other males.³ Because of this risk, men who have ever had an undescended testicle should have regular medical checkups (at least once every 2 years) throughout life. These checkups should include a testicular exam. If you have ever had an undescended testicle, talk to your doctor about how often you need to be checked. Also, learn how to do self-exams.

Last updated:	June 06, 2007
Author:	Debby Golonka, MPH
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Peter Anderson, MD, FRCS(C) - Pediatric Urology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC