What does "undescended" mean?

During the final months of pregnancy, the testicles travel from inside the abdomen down through the inguinal canal and into the scrotum. In some boys, this descent is incomplete at birth — the testicle stops somewhere along the path, in the inguinal canal, or remains in the abdomen.

This is called cryptorchidism, from Greek words meaning "hidden testicle".

How common is it?

  • Term babies: About 3% of full-term boys are born with at least one undescended testicle.
  • Premature babies: Up to 30% of premature boys are affected.
  • Spontaneous descent: Around 70% of undescended testicles will descend on their own during the first 3–6 months of life.

Why does it matter?

Three reasons make early treatment important:

1. Fertility

The testicle needs to be in the cooler environment of the scrotum to produce healthy sperm later in life. A testicle left at body temperature for years can suffer permanent damage to its sperm-producing cells.

2. Cancer risk

An undescended testicle has a slightly increased risk of testicular cancer, even after surgical correction. Bringing it down into the scrotum makes self-examination possible and any future changes easier to detect.

3. Risk of testicular torsion

An undescended testicle is more vulnerable to twisting (torsion), which is a surgical emergency.

When should it be treated?

Current international guidelines recommend that surgery — called orchidopexy — be performed between 6 months and 18 months of age, and certainly before age 2. Surgery any earlier carries higher anesthetic risk; later surgery loses some of the fertility-preservation benefit.

If a testicle has not descended on its own by 6 months, it almost certainly will not, and a surgical referral is appropriate.

What is a retractile testicle?

A retractile testicle is different from an undescended one. It is a testicle that can be brought down to the scrotum but pulls back up reflexively when the child is cold or anxious. Retractile testicles usually do not need surgery — they "settle" permanently in the scrotum during puberty. However, they should be monitored, because a small percentage become "ascending testicles" and require surgery later in childhood.

What does the surgery involve?

Orchidopexy is performed under general anesthesia. The surgeon locates the testicle, frees it from the surrounding tissue and any associated hernia sac (which is almost always present), brings it down into the scrotum, and fixes it in a small pocket so it cannot retract again.

The procedure typically takes 30–60 minutes, and the child usually goes home the same day.

Recovery

Most boys recover quickly. Activity is restricted for 1–2 weeks — no riding toys, no rough play, no climbing. The scrotal incision is small and heals well.

The repaired testicle should be examined regularly during routine check-ups, and self-examination is encouraged from puberty onward.