Undescended testis (cryptorchidism) in children is the condition where one or both testes have not descended into the scrotum (testicular sac). Normally, testes develop inside the abdomen before birth and then descend into the scrotum. However, in some children, this descent does not occur. The testes are usually found in the inguinal canal, and more rarely, inside the abdomen.

Symptoms

• Absence of testes in the scrotum,
• Palpable testes in the abdomen or groin area,
• Empty scrotum.

The exact causes of undescended testes are generally unknown. However, genetic and environmental factors are thought to play a role. Additionally, congenital anomalies and hormonal imbalances also contribute.

The most common complication is testicular atrophy, meaning the testis shrinks and disappears over time. This can lead to infertility issues. If not treated early, undescended testes increase the risk of testicular cancer. The abnormal position of the testes can also cause pain and other problems.

Diagnosis

Diagnosis is usually made by physical examination. It should be noted that testes that appear normal from the outside may also be undescended and must be examined by a pediatric surgeon. Sometimes ultrasound or other imaging methods are used to confirm the diagnosis or monitor treatment.

Treatment

Treatment involves surgical intervention called “orchidopexy,” which brings the undescended testis into the scrotum. Surgery performed early (no later than the 6th month after birth) generally yields better results. Contrary to popular belief, children with undescended testes should not be waited on until 2-3 years old. Surgery should be performed by 6 months at the latest. Otherwise, the testis will become atrophic and lose its function entirely, increasing the risk of complications mentioned above. Hormone therapies tried in the past were long-term and unfortunately ineffective, so many centers no longer use them.

Early diagnosis and treatment reduce the risk of complications and help children develop normally and live healthy lives. If your child shows signs of undescended testis, you should definitely consult a pediatric surgeon.

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