3 Ways to Treat Undescended Testes

1. Receive a Diagnosis at Birth

Undescended testes, or cryptorchidism, is characterized by one or both of the testes failing to completely descend from the abdomen into the scrotum before birth. The undescended testicles can be found anywhere along or outside of the path to the scrotum. Diagnosis of this condition is usually made during the newborn examination. If a problem is detected, the doctor must locate the missing testes within your infant's body.

This is usually done by palpating the region and using X-ray, ultrasound or magnetic resonance imaging. These tests may also reveal the presence of a uterus. The doctor confirm whether the testicles are functioning by measuring hormone levels and running additional lab tests. Cryptorchidism can be a marker of an intersex condition, hypopituitarism or other medical conditions. Locating the testes, assessing their function and ruling out any other contributing conditions is necessary to surmise the appropriate treatment.

2. Consider Hormone Therapy First

During the first year of your baby's life, doctors typically give testicles a chance to descend on their own. In most cases, this occurs in the first 3 months. After 6 months, the doctor will assess the likelihood that your child's testes will descend naturally. If the prognosis is poor, the doctor probably will recommend hormone therapy. This will consist of a series of human chorionic gonadotropin (HCG) injections, usually administered over 4 to 5 weeks.

Success rates for this therapy vary, and it is usually most effective if the original position of the testes is further away from the scrotum. In some cases, hormone therapy may cause the testicles to descend only partially, in which case surgery will be required to complete the descent. Because the likelihood of a complete descent is unpredictable, some doctors forgo the hormone therapy entirely. If your child's testes are located particularly far from the scrotum, however, hormone therapy may be used to move the testes in better position for surgery.

3. Relocate Testes With Surgery

When undescended testes fail to descend naturally or through hormone therapy, surgery is the only option. Leaving the testicles where they are will increase your child's risk of developing testicular cancer, fertility problems and psychological issues stemming from abnormal genitalia. This surgery, called orchiopexy or orchidopexy, is usually performed when the patient is between 1 and 2 years old. Typically an outpatient procedure, the surgery involves cutting open the groin, locating the testes, relocating them along with their blood supply to the scrotum and stitching them into place. In cases where the testicles are further up in the inguinal canal, laproscopy may be needed to find them, and more complicated surgery may be needed to transplant them to the scrotum. Occasionally, surgery exposes undescended testes to be non-existent or nonviable.