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Treatments and drugs
By Mayo Clinic staffThe goal of treatment is to move the undescended testicle to its proper location in the scrotum. Early treatment may lower the risk of complications of an undescended testicle, such as the risk of infertility and testicular cancer.
Surgery
An undescended testicle is usually corrected with surgery. The surgeon carefully manipulates the testicle into the scrotum and stitches it into place. This procedure usually requires relatively small incisions and may be performed with laparoscopic devices.
When your son has surgery will depend on a number factors, such as your son's health and how difficult the procedure might be. Your surgeon will likely recommend doing the surgery after your son is 3 to 6 months old and before he is 15 months old. Early surgical treatment appears to lower the risk of later complications.
In some cases, the testicle may be poorly developed, abnormal or dead tissue. The surgeon will remove this testicular tissue.
If your son also has an inguinal hernia associated with the undescended testicle, the hernia is repaired during the surgery.
After surgery, the surgeon will monitor the testicle to see that it continues to develop, function properly and stay in place. Monitoring may include:
- Physical exam
- Ultrasound examination of the scrotum
- Tests of hormone levels
Hormone treatment
Hormone treatment involves the injection of human chorionic gonadotropin (HCG). This hormone could cause the testicle to move to your son's scrotum, but hormone treatment is usually less effective than surgery is. There's some evidence that hormone treatment may contribute to early onset of puberty (precocious puberty).
Other treatments
If your son doesn't have one or both testicles — either missing or didn't survive after surgery — you may consider saline testicular implants for the scrotum that can be implanted during late childhood or adolescence. These implants — testicle-shaped nodules filled with a fluid — result in the "appearance" of two testicles in the scrotum.
If your son doesn't have at least one healthy testicle, your doctor will refer you to a hormone specialist (endocrinologist) to discuss future hormone treatments that would be necessary to bring about puberty and physical maturity.
- Elder J. Disorders and anomalies of the scrotal contents. In: Kliegman R, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders, Elsevier; 2007. http://www.mdconsult.com/das/book/body/102535550-2/0/1608/1246.html?tocnode=54484554&fromURL=1246.html#4-u1.0-B978-1-4160-2450-7..50547-8_9817. Accessed Aug. 15, 2008.
- Hutson JM, et al. Current management of the undescended testicle. Seminars in Pediatric Surgery 2007;16(1):64-70.
- Barthold JS. Undescended testis: Current theories of etiology. Current Opinion in Urology. 2008;18(4):395-400.
- Kelsberg G, et al. Clinical inquiries. When should a child with an undescended testis be referred to a urologist? Journal of Family Practice. 2006;55(4):336-337.
- Cooper, CS. Undescended testicle (cryptorchidism). www.uptodate.com/home/index.html. Accessed July 25, 2008.
- Esposito C, et al. Management of boys with nonpalpable undescended testis. Nature Clinical Practice Urology. 2008;5(5):252-60.
- Liptak GS. Genital defects. The Merck Manuals Online Medical Library. http://www.merck.com/mmhe/sec23/ch265/ch265d.html. Accessed Aug. 19, 2008.
