Parents react in a variety of ways when it is discovered that their newborn has an undescended testicle. Some may panic under the impression that there’s something “wrong” with their child; others may take a wait-and-see attitude; still others may not consider it a problem at all. The fact is that pediatricians highly recommend the situation be resolved within 6 to 12 months of baby’s birth.
Undescended testicles, also known as cryptorchidism, is a fairly common and usually painless congenital condition where one – or sometimes both – of the baby's testicles have not moved into the proper position. The situation occurs in about 1% of full-term babies, but in roughly 30% of premature births.
In some cases, the testicle will descend on its own as the infant develops. However, we strongly encourage surgery if this has not happened by the six-month mark.
Why is this so important? Undescended testicles that are addressed too late (by age 2), or are not addressed at all, can lead to serious health problems later, increasing the likelihood of developing hernias, testicular cancer and infertility.
Fixing the problem involves a simple surgery called an orchidopexy. After the baby receives general anesthesia, an incision is made in the groin above the pubic bone on the side where the testicle has not descended. The surgeon then locates the undescended testicle, after which they will make a small incision in the scrotum to create a pouch that will hold the testicle. Using surgical instruments, the surgeon then gently pulls the undescended testicle into the pouch, securing it in place with dissolvable stitches – which are also used to close both incisions. The surgery typically takes 60 to 90 minutes.
Post-surgery, the baby will likely need appropriate doses of ibuprofen or acetaminophen to help manage their pain, and should only play quietly for 48 hours. (This can be easier said than done in some cases, but it is important to allow the incisions to heal properly.) They should not play on toys that they straddle for two weeks.
In some cases, the undescended testicle may be higher in the abdomen, near the child’s tummy. The surgeon would then likely use a laparoscope – a small tube with a camera on it that is placed through a small incision in the belly. After locating the testicle, the procedure is similar to that of the orchidopexy.
No parent wants their child to undergo surgery of any kind – especially with an infant. But in cases such as these, it is important to have the surgery performed; again, it is not considered to be major. Your pediatrician can advise you on the best steps to take, which likely will lead you to a pediatric urologist.
Dr. Amanda C. North is Chief of Pediatric Urology and an attending physician at the Children’s Hospital at Montefiore (CHAM). To make an appointment, call 914-849-5437.