Undescended testes is defined as a failure of one or both of the testes to descend in to the scrotum at birth. During development, the testes first appear rather high in the pelvis. As the fetus gets closer to being born, the testes descend from the pelvis to the scrotum, where they ultimately belong. Sometimes this does not happen as it should. In medical terms, this condition is known as cryptorchidism.

Undescended testes in newborn boys is a common event. It is estimated that up to 3% of boys who are born full term, and about 30% who are born premature, will have one or both of their testicles fail to descend in to the scrotum at birth. In a vast majority of these cases, the testes will properly position themselves without treatment by the boy's first birthday.

Why does this problem happen in some boys? The answer is simple: we don't know. There is some evidence that undescended testes could be related to hormone deficiencies in either the mother or fetus during the pregnancy, but no definite relationship has been identified. In some cases, an abnormal growth of tissues in the path that the testes are meant to travel as they descend can block the normal movement of the testes.

The only known risk factor for the development of an undescended testicle is having a family member who had the same problem. However, it's very unlikely anyone ever asked Uncle Joe or Cousin Bob what the state of his testicles were when he was born, so this often has little predictive value.

There is nothing that a pregnant woman can do to lower the risk of having a boy with an undescended testicle.

So, if most cases of cryptorchidism resolve on their own, and there is nothing you can do to prevent the condition, why are you reading about it?

Unfortunately, there are some potential complications if the condition does not resolve on its own.

There is an increased risk of developing testicular cancer in boys who had an undescended testicle as an infant. Interestingly, in cases where only one of the testes fails to descend, the risk of cancer is increased for both testes. No one knows why this happens.

Boys with undescended testes are more likely to be sterile or have decreased fertility. If the problem is not corrected before the boy is older, it is possible to suffer psychologically from issues related to self-image. Lastly, as if all those other problems weren't bad enough, there is an increased rate of hernias in boys with cryptorchidism.

When a baby is born, it is part of the routine check of the infant to determine if the testes have descended properly. If the doctor or midwife who is doing examination is unable to feel the testes, there are some exams which can be done to confirm the problem. Ultrasounds or CAT scans can be done to create an image of the scrotum and look for the testes directly. Once the diagnosis of cryptorchidism is made, a decision must be made regarding treatment.

Most cases of cryptorchidism will resolve on their own before the boy is one year old. However, in some cases surgical correction may be necessary to lower the testicle into the infant's scrotum. In most cases, this surgery is delayed until the infant is over a year and a half old. Some doctors have tried injections of hormones as a treatment. A hormone known as hCG can be injected into the infant in an attempt to induce the testicles to descend.

Learn more about this author, Erich Rosenberger M.D..
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