When your baby boy is born with an undescended testicle, you won’t need to take any steps right away. Normally, the testicles move from the lower belly into the scrotum -- the pouch of skin below the penis -- before birth. But even when they don’t, and your baby’s born with one or both undescended, they usually drop into place on their own within a few months.
If it hasn’t happened by the time your baby is 6 months old though, your doctor will likely suggest surgery.
It’s the most common treatment, and it nearly always works.
Why Would My Doctor Suggest Surgery?
Most doctors now suggest surgery when your baby is 6 to 12 months old. Waiting at least 6 months lets you see whether the testicle will drop on its own. But waiting longer than 12 months may increase the odds that your son will have fertility problems later in life.
Men who had surgery for one undescended testicle have almost the same fertility level as if they never had a problem. And for men with two undescended testicles, fertility is usually improved with the procedure but is still at a lower level than normal.
There are other benefits to surgery as well. Men who have an undescended testicle have a slightly higher chance of getting testicular cancer, even after surgery. But the procedure makes it easier to do self-exams and catch cancer early on, if it happens.
The surgery may also lower the odds for or even prevent:
- Hernias. This is when tissue bulges through muscle in the lower belly
- Injuries. An out-of-place testicle is more likely to get damaged
- Testicular torsion. This is when the cord that carries semen to the penis gets twisted up and cuts off blood flow to the testicles
- Embarrassment. Some boys will worry that their testicles look different
What Happens During the Surgery?
The surgery varies based on where the undescended testicle is located: in the groin or the lower belly. In both cases, your baby gets medication so that he will not be awake or feel pain during the procedure. Typically, the operation takes about an hour per testicle, and your baby goes home the same day.
If your boy also has a lower belly hernia, which is common with an undescended testicle, your doctor will also fix that.
Groin: This is the simpler and more common surgery. The doctor will:
- Make a small opening in the groin to find the testicle.
- Gently move the testicle down.
- Make a small cut in the scrotum and stitch the testicle into place.
- Close the openings with stitches that dissolve on their own.
Lower belly: Your doctor will likely do what’s called laparoscopic surgery. This uses tiny holes, like small keyholes, instead of longer cuts.
In some cases, your doctor will find that the testicle isn’t there at all or hasn’t grown well and needs to be removed. If the testicle has to come out, he may suggest waiting until puberty because it may still produce hormones, so there’s benefit in waiting until then.
During surgery, the doctor will:
- Make keyhole openings in the lower belly and groin (both sides of the groin if both testicles are undescended)
- Use the openings to place a camera and tools to find the testicle
- Make a small opening in the scrotum to create a pouch for it
- Gently move the testicle down
- Stitch it into place
- Close the openings with stitches that dissolve on their own
Sometimes, this surgery is done in two stages. First, the doctor finds the testicle and moves it part way down. Then, a year or two later, the doctor will move it all the way into the scrotum. This is done to give a better blood supply to the testicle as it grows.
How Long Does It Take to Heal?
Your doctor will likely suggest pain medicine for the first couple of days. For the first 24 hours, your baby may seem out of sorts as the medication from surgery wears off, but most kids feel better within a day.
To help your baby heal:
- Avoid bathing for at least the first 2 days.
- Don’t let your child ride a bike or use toys he sits on for a few weeks. Check with your doctor to see when your baby can get back to normal fun and games.
- Dress him in loose-fitting clothes. His groin may be tender.
- Have him drink plenty of fluids.
- Use diapers if needed, but change them often and leave them off for short periods of time.
Your doctor will follow up after the surgery to make sure the testicle grows and works as expected. You can expect yearly exams as well, where your doctor may test hormone levels and use imaging to check your child’s scrotum.