Diagnosing Undescended Testicles

NYU Langone pediatric urologists—doctors who specialize in managing congenital urinary tract problems—offer expert diagnosis of undescended testicles.

A testicle is small and egg-shaped. The testicles are located in a sac called the scrotum, and are responsible for sperm and hormone production. In boys with cryptorchidism, or undescended testicles, one or both testicles fail to move down into the scrotum—either before birth or shortly afterward.

The testicles form in an unborn baby’s abdomen. Before birth, the testicles slowly descend from the abdomen through the inguinal canal, a tube-like passageway in the groin, into the scrotum.

If this process stops or is delayed, one or both testicles may fail to descend. If one testicle is affected, it is called unilateral cryptorchidism; if both are affected, it is called bilateral cryptorchidism.

In many babies, undescended testicles move into the scrotum by the time a child is 3 to 4 months old. If the testicles do not descend by the time a child is 6 months old, NYU Langone doctors recommend surgical treatment to prevent changes that can affect fertility later in life.

Physical Exam

Doctors usually diagnose undescended testicles during a physical exam performed immediately after birth or shortly thereafter.

The doctor can usually feel, or palpate, the undescended testicles during the exam. However, in some boys, the undescended testicles may not be located in an area that can be felt. Many times, testicles that are not palpable are located inside the abdomen.

A physical exam helps your child’s doctor rule out the presence of a retractile testicle, in which the testicle is temporarily pulled into the groin due to a muscle reflex.

During puberty, the testicles enlarge and remain in the scrotum after that time.

Although treatment is generally not needed, boys with a retractile testicle should have an annual examination with a pediatrician or pediatric urologist to check to see if the testicle can be brought into the scrotum. Some retractile testicles may become undescended prior to puberty, so an annual examination is needed until this time.

Ultrasound Scan

Your child’s doctor may order a pelvic ultrasound to determine the exact location of an undescended testicle if it is not easily felt or palpable.

In this imaging test, the doctor places a device called a transducer on your baby’s groin and abdomen. The transducer emits high frequency sound waves that produce a computerized image of the reproductive organs.