Cryptorchidism (Undescended Testis)

Treatment: Truly undescended testes will require surgical correction. If performed at the earliest time after about six months of age, maximum preservation of testis function can be expected.

Surgery: An inguinal incision is made. If the testis is located, it is freed from the tethering tissues and dissected away, preserving the normal blood vessels and sperm duct. It is then brought down to the scrotum through a tunnel and secured in the scrotum. Most children go home the day of surgery. Occasionally the incision is modified to look for a deep intra-abdominal testis. All testes with good potential for function are brought down. Atrophic or dead testes are removed.

Follow-up: All stitches are absorbable and do not need removal. The child will return for an office visit four to six weeks following surgery. Further follow-up will be determined at that visit. Most children tolerate this surgery well with minimal problems. It is one of the most common procedures done by pediatric urologists.

Long-Term Issues:

• Testis malignancy: The risk of testicular cancer is increased in an undescended testis. Whether this risk is reduced by bringing the testis down is unknown at this time. A testis in the scrotum is easy to examine, and all children who undergo surgical correction must be taught to perform testis self-exams by puberty

• Reduced fertility: Fertility may be significantly reduced if both testes are undescended. In most cases of one undescended testis, where at least one testis is normal, fertility will be normal.