Undescended Testicles (Undescended Testes) in Children

What are undescended testicles?

An undescended testicle (also known as cryptorchidism) occurs when one or both testicles have not moved down into the scrotum before birth. It is one of the most common conditions affecting baby boys, particularly those born prematurely.

In many babies, the testicle will descend naturally during the first few months of life. However, if it has not reached the scrotum by around six months of age (corrected age for premature babies), it is unlikely to descend on its own and treatment is usually recommended.

Early diagnosis and treatment can help support normal testicular development, improve future fertility potential and reduce the risk of complications later in life.

What are the symptoms?

Most parents do not notice any symptoms other than one or both sides of the scrotum appearing empty or less developed than expected. The condition is often identified during a routine newborn examination or child health check.

Occasionally, an undescended testicle may move between the groin and the scrotum. This is known as a retractile testicle, which is different from an undescended testicle and often does not require surgery. Your consultant will be able to distinguish between these conditions during the examination.

When should I seek medical advice?

If your baby's testicle has not descended by six months of age, it is recommended that they are referred for assessment by a paediatric surgeon.

You should also seek medical advice if:

• You notice an empty scrotum on one or both sides
• A previously descended testicle appears to have moved upwards
• Your child develops pain or swelling in the groin or scrotum
• You are concerned about the appearance of your child's testicles

Sudden pain and swelling in the scrotum should always be treated as an emergency, as this may indicate testicular torsion, which requires immediate medical attention.

How are undescended testicles diagnosed?

Diagnosis is usually made during a physical examination. An experienced paediatric surgeon can often feel whether the testicle is located in the groin or determine if further investigation is required.

In most children, imaging such as an ultrasound scan is not routinely necessary before referral, as a specialist examination provides the most useful information. If the testicle cannot be located, additional investigations or a minimally invasive procedure called laparoscopy may occasionally be recommended.

What treatment is available?

If the testicle has not descended naturally by around six months of age, surgery is usually recommended.

The operation, known as an orchidopexy, involves carefully moving the testicle into the scrotum and securing it in its correct position. The procedure is performed under a general anaesthetic and is usually completed as a day-case operation, allowing your child to return home later the same day.

Early surgery, ideally before 12 months of age and generally before 18 months, offers the best opportunity to support healthy testicular development and reduce the risk of future complications.

Recovery after orchidopexy

Most children recover quickly after surgery. Mild discomfort, bruising and swelling around the groin or scrotum are normal during the first few days and are usually well managed with simple pain relief.

Your child should avoid vigorous physical activity, rough play, cycling and straddling toys for a short period while healing takes place. Most children can return to nursery or school within a few days, depending on their age and comfort.

A follow-up appointment may be arranged to ensure the testicle remains in the correct position and is developing normally.

Why is early treatment important?

Leaving an undescended testicle untreated can increase the risk of future problems, including reduced fertility, testicular injury and, later in life, a higher risk of testicular cancer. Although surgery cannot completely eliminate these risks, early treatment significantly improves long-term outcomes.

Our paediatric surgeons are experienced in diagnosing and treating undescended testicles and will guide you through every stage of your child's care. We understand that surgery can feel worrying for parents, and we are committed to providing expert, compassionate care in a child-friendly environment.