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Treatments and drugs
By Mayo Clinic staffA retractile testicle is likely to descend on its own before or during puberty. If your son has a retractile testicle, your son's doctor will monitor any changes in the testicle's position in annual evaluations to determine if it stays in the scrotum, remains retractile or has become an ascending testicle.
If the testicle has ascended — no longer movable by hand — or if it's still retractile by age 14, your son's doctor may recommend treatment. The goal of treatment is to have the testicle permanently descend, which may lessen the risk of complications. Treatments include:
- Surgery. A surgical procedure called orchiopexy moves the testicle permanently into the scrotum. Through one incision in the groin and another in the scrotum, the surgeon guides the testicle to its proper position and stitches it into place. Follow-up exams are usually recommended. Ask your child's doctor how often he needs to be seen.
- Hormone therapy. Because descent of the testicle is partially regulated by hormones, descent can sometimes be induced with hormone therapy using human chorionic gonadotropin (HCG) injections. Possible side effects include increased penis and testicular size, pubic hair growth and aggressive behavior.
It is important to understand that even with successful treatment of an ascending or retractile testicle, the increased risk of testicular cancer remains. However, surgical treatment before puberty can lessen the risk of testicular cancer, and the overall risk of testicular cancer is quite low.
Adolescent boys and men who have had treatments to correct an ascending or retractile testicle should regularly monitor the position of the testicle to ensure it doesn't ascend at a later 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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