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Tests and diagnosis
By Mayo Clinic staffIf your son has a testicle not located in the scrotum, his doctor will determine its location in the groin. Once it's located, the doctor will attempt to guide it gently into its proper position in the scrotum.
Your son may be lying down, sitting or standing during this examination. If your son is a toddler, the doctor may have him sit with the soles of his feet touching and knees to the side. Older boys may be asked to squat. These positions often make it easier to find and manipulate the testicle. In addition, it's important that this exam is done in a warm location and that the doctor has warm hands, because cold can stimulate the cremaster reflex.
If the testicle is a retractile testicle, it will move relatively easily and painlessly. The retractile testicle won't immediately move up again. Your son's doctor can then stimulate the reflex of the cremaster muscle by gently rubbing the upper inside of the thigh. This stimulation will usually cause the retractile testicle to move up again.
If the testicle in the groin moves only part way into the scrotum, if the movement causes pain or discomfort, or if the testicle immediately retreats to its original location, it's most likely not a retractile testicle. In such cases the testicle would be considered undescended or ascending if the testicle had been in the scrotum at one time.
- Agarwal PK, et al. Retractile testis — Is it really a normal variant? Journal of Urology. 2006;175:1496.
- La Scala, et al. Retractile testes: an outcome analysis on 150 patients. Journal of Pediatric Surgery. 2004;39:1014.
- Cooper CS, et al. Urology. In: Doherty GM. Current Diagnosis and Treatment: Surgery. 13th ed. New York, N.Y.: McGraw-Hill Medical; 2010. http://www.accessmedicine.com/content.aspx?aID=5312459. Accessed March 10, 2010.
- Stec AA, et al. Incidence of testicular ascent in boys with retractile testes. Journal of Urology. 2007;178:1722.
- Anatomic disorders. In: Rakel RE. Textbook of Family Medicine. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/188759382-2/966699837/1481/588.html?printi. Accessed March 11, 2010.
- Pettersson A, et al. Age at surgery for undescended testis and risk of testicular cancer. New England Journal of Medicine. 2007;356:1835.
- Charles JC. The fate of the retractile testicles. Journal of Urology. 2003;171:1237.
- Hack WW. Natural history and long-term testicular growth of acquired undescended testis after spontaneous descent or pubertal orchidopexy. BJU International. In Press. Accessed March 12, 2010.
- Sandlow JI, et al. Surgery of the scrotum and seminal vesicles. In: Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/188759382-2/966699837/1445/37.html?printin. Accessed March 11, 2010.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. March 15, 2010.
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