Undescended testes (UDT) refer to normal testes that sit above the scrotum and cannot be easily milked down into the scrotum. Undescended testes are commonly seen in newborn males, particularly if premature. Testes should descend normally within the first six months of life. If the testes do not descend normally, it increases the risks of complications including testicular torsion, lowered fertility, hernias and testicular tumours (to a small degree).
Retractile testes refer to testes that sit above the scrotum and are easily milked down into the scrotum.
Acquired undescended testes are testes that have previously sat in the scrotum and are now sitting above the scrotum and cannot be easily milked down.
It is important to distinguish between UDT and retractile testes given the vastly different management strategies. Retractile testes can be easily milked down into the scrotum, the scrotum is generally well formed and normal or near-normal size, and the parents may report at times seeing the testes in the scrotum.
Distinguishing UDT/retractile testes from other groin lumps is generally simple.
- Lymph nodes are generally more lateral, superficial and not mobile
- Hernias extend from the inguinal ring and are compressible or reducible
- Hydroceles are located in the scrotum (although can extend above) and are immobile and transilluminable
- Encysted hydroceles of the cord are less common and often a little harder to distinguish, however they are generally immobile.
- It is important to distinguish between UDT and retractile testes given the vastly different management strategies.
- Undescended testes (UDT) over the age of 6-12 months or acquired UDT should be referred for paediatric surgical opinion and likely orchidopexy.
- Retractile testes can simply be monitored clinically and do not require surgical correction.
Investigations are rarely required in diagnosing UDT. Ultrasound of the groin is only of use when there is suspected absence of the testes (even in the groin).
Undescended testes (UDT) over the age of 6-12 months should be referred for paediatric surgical opinion and likely orchidopexy.
Retractile testes can simply be monitored clinically and do not require surgical correction.
Acquired UDT should be referred for paediatric surgical opinion and likely orchidopexy.
- Paediatrician
- Referral to paediatric outpatient services is not appropriate in the management of UDT unless there is felt to be underlying syndromic associations.
- Paediatric surgical services
- Ballarat Health Services Urology Department will undertake orchidopexy on children without significant co-morbidites (e.g. extreme prematurity).