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Tests and diagnosis
By Mayo Clinic staffYour doctor can easily determine that a testicle hasn't descended into the scrotum. The goal of further examination is to locate the position of the testicle and monitor changes in its position. If the testicle is in the groin, your doctor may be able locate it by touch. If it can't be felt (nonpalpable), then he or she will likely refer you to a pediatric urologist for further tests. Some undescended testicles are nonpalpable.
If your son has a nonpalpable testicle, the pediatric urologist may order one or more of the following procedures:
- Ultrasound. An ultrasound is a noninvasive device that uses sound waves to create images of internal structures of the body. An ultrasound may enable the pediatric urologist to locate a nonpalpable testicle, particularly if it's located within the groin.
- Magnetic resonance imaging (MRI) with a contrast agent. MRI is a technology that uses a magnetic field and radio waves to create images of soft tissues in the body. A contrast agent injected into the bloodstream can improve the imaging capability of the procedure. This procedure may enable your pediatric urologist to locate a testicle in the groin or abdomen.
- Laparoscopy. This procedure is generally considered the best choice for locating a nonpalpable undescended testicle. Laparoscopy uses a tiny video device connected to a tube that a surgeon inserts through a small incision in your son's abdomen. Images appear and can be enlarged on a video screen. Surgical correction of the undescended testicle may be done during the same procedure.
- Open surgery. Direct exploration of the abdomen through a larger incision may be necessary in a small number of more complicated cases.
Other diagnostic issues
If your infant has two nonpalpable undescended testicles, your doctor may order tests to determine the sex of your child. The "absent" testicles may, for example, be because your child is genetically a female, but has external male genitals. This condition of unclear biological sex is called ambiguous genitalia, or intersex. Tests to check the possibility of ambiguous genitalia include:
- Measurements of various hormone levels in blood and urine
- Analysis of your baby's sex-related genes
- Ultrasound investigation for female sex organs (ovaries)
- Ashley RA, et al. Cryptorchidism: Pathogenesis, diagnosis, treatment and prognosis. Urologic Clinics of North America. 2010;37:183.
- Cryptorchidism. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-0-323-05610-6..00012-3--sc0255&uniq=213947045&isbn=978-0-323-05610-6&sid=1037085104#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-0-323-05610-6..00012-3--s5575%3Bfrom%3Dcontent%3Bisbn%3D978-0-323-05610-6%3Btype%3DbookPage. Accessed Aug. 12, 2010.
- Elder JS. Disorders and anomalies of the scrotal contents. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/213947045-4/1037087645/1608/1246.html#4-u1.0-B978-1-4160-2450-7..50547-8--cesec4_9821. Accessed Aug. 12, 2010.
- Cooper CS, et al. Undescended testes (cryptorchidism) in children and adolescents. http://www.uptodate.com/home/index.html. Accessed Aug. 12, 2010.
- Braunstein GD. Endocrinology and the life span. In: Kronenberg HM, et al. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/213947045-6/1037085104/1555/158.html#4-u1.0-B978-1-4160-2911-3..50026-1--cesec117_2351. Accessed Aug. 12, 2010.
- Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 15, 2010.
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