Treatment for Undescended Testicle
Treatment for undescended testicle may include manipulation into the scrotum (in cases of retractile testes), hormone therapy, and surgery. Treatment is not recommended until after the age of 1 year, because in most cases, the testis descends without intervention during this time.
The goals of treatment include the following:
- Improve fertility
- Promote easier examination for testicular cancer (earlier detection)
- Correct associated abnormalities (e.g., hernia)
- Prevent testicular torsion
- Alleviate psychological concerns regarding body image
- Reduce risk for injury (especially if the testis is positioned near the pubic bone)
Hormonal therapy with human chlorionic gonadotropin hormone (hCG) is used with some success when the testis is not located within the abdomen. Hormone injections are administered twice per week, for 5 weeks. Side effects include increased scrotal folds or creases, increased skin pigmentation, penile growth, and pubic hair. These effects regress when treatment is discontinued. This therapy may be combined with gonadotropin-releasing hormone (GnRH) therapy, but has not been approved in the United States.
Surgery for an undescended testicle is called orchidopexy or orchiopexy. If the testicle is located outside of the abdomen (i.e., in the groin), the procedure is performed under general anesthesia and the patient is usually discharged the same day.
In this procedure, which takes approximately 90 minutes, the testicle is located, removed through a small incision, and placed into the scrotum through another small incision. The testicle may be sutured into place. Bed rest is recommended for 2 or 3 days following orchidopexy and strenuous activity should be avoided for approximately 1 month. Success rates for this procedure are generally good and fertility is usually achieved.
An undescended testicle that remains in the abdomen is located in an exploratory laparoscopy. In this procedure, a small incision is made near the navel and a telescope-like instrument that consists of a tiny camera and a light (laparoscope) is inserted to allow the physician to see inside the abdomen and locate the testicle. The physician then removes the testicle (if it is malformed) or performs orchidopexy. Success rates for this procedure are lower than if the testicle is located outside of the abdomen.
Undescended Testicle Complications
Complications from orchidopexy include adverse reactions to anesthesia, bleeding, and infection.
Undescended Testicle Prognosis
Undescended testicles usually descend into the scrotum without intervention within the first year of life. The prognosis for fertility in these cases, as well as those that are surgically corrected, is good.