This condition is when your child’s testicles are not in their usual place in the scrotum. While a baby boy is in the womb, the testicles are developing inside his abdomen. Towards the end of pregnancy, the testicles travel through a passage into the scrotum. Both testicles should be in the scrotum by the time your child is one year old. Generally, only one of the testicles is affected, but on rare occasions, both testicles fail to travel to the scrotum.
In some boys, the testicles may be in the scrotum for much of the time but cannot be felt there because they naturally rise back into the body through fear or cold temperatures.

You can usually find this out by putting your child in a warm bath and checking whether you can feel both testicles. If this is the case, there is no cause for concern.

Usually, there will not be any symptoms at all with this condition, other than not being able to feel the testicles in the scrotum. A child would not be in pain, and the undescended testicles will not interfere with any bodily function.

However, if one of the testicles becomes twisted (testicular torsion), this will be painful, either in the groin area or the abdomen, depending on the location of the testicle at the time.

Your child’s doctor will need to determine whether the testicles are truly undescended or whether they have slid back into the body temporarily. This is usually done by feeling the abdomen and the scrotum.

On rare occasions, the testicle does not descend due to other problems with the testicles themselves or with the male hormones.
We do not know exactly why this happens, but it is not due to anything that happened during pregnancy. In fact this condition is more common in premature babies. Around one in 20 male babies is born with an undescended testicle. In about one in 70 cases, the testicle remains undescended.

The choice of treatment depends mainly on the suspected cause. However, whatever the cause, undescended testicles are best treated in early childhood. The child’s testicles will need treatment as they do not seem to mature properly if left in the abdomen. The amount of sperm and fertility levels seem lower in men who have had undescended testicles, and even lower if they were not treated early in childhood. This is because the testicles need to be a few degrees cooler than the rest of the body to produce sperm. It is also impossible for men with undescended testicles to check for testicular cancer, as the testicles cannot be felt in the abdomen. If the testicles remain in the abdomen, this also increases the risk of testicular torsiona.

If the doctors suspect the testicles have not descended in a boy due to a hormone problem, they may suggest a short course of hormone treatment.
If the doctor does not suspect a hormone problem, or if the testicles remain in the abdomen after the hormone treatment, the child will need a short operation under general anaesthetic called an orchidopexy.
This is an operation to bring the testicles down from the abdomen to their usual place in the scrotum. This is a short operation under general anaesthetic, lasting about 45 minutes. In many cases, this can be as day surgery - your child will arrive at the hospital, have the operation and be able to go on the same day. Occasionally, a child will need to stay in hospital overnight.

It si defeintley a nerve wracking time for all concerned but on the operation day, your child’s surgeon will explain the operation in more detail, discuss any worries you may have and ask for your permission for the operation by asking you to sign a consent form. An anaesthetist will explain your child’s anaesthetic in more detail. If your child has any medical problems, such as allergies, please tell the doctor.

The orchidopexy can either be carried out using traditional open surgery or keyhole surgery. The surgeon will move the testicle down into the scrotum, and close up the passage through which the testicle should have travelled, to stop the testicle moving back into your child’s abdomen.

On rare occasions, the surgeon will find that the testicle has not formed properly or has been damaged while in the abdomen. If this is the case, he or she will remove the damaged testicle and might secure the healthy one in the scrotum to ensure your child’s remaining testicle remains in place and can develop in the normal way. Sometimes it takes two operations to bring the testicle down to the correct place.