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Undescended Testicles (Cryptorchidism)

Summary

Cryptorchidism, or undescended testicles, occurs when one or both testicles do not move into the scrotum before birth. This condition is diagnosed through a physical exam. About 70% of cases involve testicles that can be felt in the upper scrotum or groin, while the remaining cases involve testicles that are not palpable, possibly due to being located inside the abdomen, underdeveloped, or absent.

Undescended testicles should naturally descend within the first few months of life. If they have not descended by 6 months of age, it is unlikely they will do so on their own, and medical evaluation is necessary.

Diagnosis and When to Seek Help

Parents should consult a doctor if:

  • One or both testicles are not present in the scrotum
  • A previously descended testicle appears to have moved back up (testicular ascent)

A referral to a specialist should be made by 6 months of age, and if needed, surgery should be performed before the child turns one. Boys with both testicles undescended at birth should be evaluated immediately, as this may indicate a genetic or hormonal condition.

Diagnosis and When to Seek Help

The primary treatment for cryptorchidism is surgery (orchidopexy), typically performed between 6 and 12 months of age. This procedure moves the testicle into the scrotum, reducing the risks of future complications.

Early treatment is important because delayed correction can lead to:

  • Reduced fertility
  • A higher risk of testicular cancer
  • Increased risk of testicular torsion or hernia

Management

The primary treatment for cryptorchidism is surgery (orchidopexy), typically performed between 6 and 12 months of age. This procedure moves the testicle into the scrotum, reducing the risks of future complications.

Early treatment is important because delayed correction can lead to:

  • Reduced fertility
  • A higher risk of testicular cancer
  • Increased risk of testicular torsion or hernia

Follow-Up and Monitoring

After surgery, regular follow-ups ensure the testicle remains in place and develops properly. Boys with a history of undescended testicles should also be monitored long-term for potential fertility concerns or rare complications.

If you suspect your child has undescended testicles, early evaluation by a doctor is key to ensuring proper development and reducing future health risks.

History and Exam

Key diagnostic factor

  • Presence of risk factors
  • Malpositioned or absent testis
  • Palpable cryptorchid testis
  • Non-palpable testis

Other diagnostic factors

  • Testicular asymmetry
  • Scrotal hypoplasia or asymmetry
  • Retractile testis
  • Ascending cryptorchidism

Risk factors

  • Family history of cryptorchidism
  • Prematurity
  • Low birth weight (<2.5kg) and/or small for gestational age
  • Environmental exposures

Diagnostic Investigations

1st investigations to order

  • Clinical diagnosis

Investigations to consider

  • Ultrasound
  • Magnetic resonance imaging (MRI)
  • Hormonal evaluation with human chorionic gonadotrophin (hCG) stimulation test
  • Hormonal evaluation with Mullerian inhibiting substance (MIS), inhibin B, and follicle-stimulating hormone (FSH)

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    Other Related Conditions

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      Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

      Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

      In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

      Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

      Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections. 

      At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

      Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

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      • Initial consultation and history gathering
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      Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

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