With undescended testicles, either one or even both testicles are located outside the scrotum. They can then be located in the groin or abdomen, for example. This can lead to problems, such as a later inability to conceive. The cause of undescended testicles is not yet clear.
You can find more information and selected undescended testicle specialists below.
The testicles are part of the male reproductive organs. They play a decisive role in the production of sperm and therefore play an important role in fertility.
Undescended testicles are an embryonic malformation in which one or both testicles develop outside the scrotum. They are often located in the groin or abdomen instead. The medical term for undescended testicles is maldescensus testis.
The cause of undescended testicles is not yet clear. Hormonal disorders or anatomical obstacles that prevent the testicle(s) from moving from the trunk into the scrotum are suspected.
A distinction is made between different types of undescended testicles.
With an inguinal testicle, the testicle is stuck in the upper groin area and cannot make its way into the scrotum. Inguinal testicles are the most common form of undescended testicles and require treatment.
In the case of an abdominal testicle, the descent of the testicle into the scrotum has already stopped in the abdominal cavity.
This form of undescended testicle also requires treatment. Otherwise, it can later lead to health problems such as inability to conceive or even tumors.
A gliding testicle is located just above the scrotum in the groin area. Although the testicle can be moved into the scrotum, it then slides back into the area above the scrotum. This is where the name sliding testicle comes from.
The reason for the sliding back is that the spermatic cord is too short.
Although the pendulum testicle is generally located in the scrotum, it can be pulled upwards by certain reactions or reflexes. This involves tensing a specific muscle, the cremaster muscle.
Cold or sexual arousal can be factors that promote the tensing of this muscle.
In undescended testicles, one or both testicles are not in the scrotum © Maryna Vladymyrska | AdobeStock
Undescended testicles can have genetic causes as well as being favored by external influences.
Genetic causes include a defect in the genetic material. This defect can also lead to other malformations. These can then make the correct descent of the testicles into the scrotum more difficult or even prevent it altogether.
External influences can include, for example, smoking or alcohol consumption during pregnancy. However, other influences such as environmental toxins or diabetes in the mother can also contribute to undescended testicles.
Other risk factors for the development of undescended testicles are
In addition, specific medications during pregnancy, for example paracetamol, can cause undescended testicles. Studies have shown indications of such a connection ("weakly significant associations"). However, further research is needed to prove the connection beyond doubt.
Undescended testicles are the most common genital malformation in male babies: 3% of newborns and 30% of premature babies are diagnosed with undescended testicles. For this reason, attention is already paid to this in newborns.
To determine the form of undescended testicles, the doctor carries out a number of examinations. Sonography (ultrasound) can be used to objectify the position of the testicles if they are not clinically palpable (= can be felt under the skin).
If the ultrasound does not reveal a testicle, a laparoscopic testicle search should be performed.
Boys who have been diagnosed with undescended testicles should undergo treatment as soon as possible. Without treatment, those affected may be unable to conceive as adults. The temperature in the abdominal cavity or in the groin area is slightly higher than in the scrotum.
However, in the case of unilateral undescended testicles, the other testicle may be able to compensate for the loss of the undescended testicle.
Other risks may include testicular tumors. The probability of a tumor increases if undescended testicles are left untreated.
An undescended testicle should be treated as soon as possible. The aim is to have completed treatment by the time the child is 12 months old. The corrected age applies to premature babies.
Sometimes the testicle moves spontaneously to the correct position within the first six months of life. Treatment of the affected testicle should therefore only begin after six months.
After the 6th month , hormone therapy with
can be administered. Hormones are administered that are also responsible for the normal descent of the testicles during pregnancy.
According to the guidelines, hormone therapy has two objectives:
Hormone therapy is unfortunately not very promising in many cases , with the exception of sliding testicles: statistically, hormone therapy only works in one in five patients. In addition, it can lead to various side effects, such as pubic hair growth or enlargement of the genitals.
Surgical therapy is therefore the primary treatment for all other forms. Various procedures are used for this, such as
There are several methods for this.
The sooner the operation is performed, the lower the risk of secondary diseases.
In rare cases, atrophy of the testicle occurs as a complication after the operation. This means that the testicle atrophies due to tissue atrophy.
Recurrence, in which the testicle retracts back into the groin, is much rarer.
Even after a successful operation, parents should consult a doctor if certain changes occur - for example, if the testicles grow. It is therefore advisable for patients to learn to look out for such signs at an early stage.
The doctor of choice for an undescended testicle and its accompanying symptoms is the urologist.
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