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Urinary and Genital Disorders (Children)

Toddler physical development

09/08/1998

Question:

My 2 1/2 year old son's testicles do not stay descended in the scrodum. They never have. As an infant, the pediatrician assured me that as he got older and lost his baby fat and started walking, that the testicles would eventually stay down; however they don't. In fact, they are 99% of the time up when I change his diaper. Do you think there is need for concern?

Answer:

It is not uncommon for boys to have testicles that do not stay in the scrotum. The key issue is whether on physical examination, one is able to milk the testicles down into the scrotum without tension. If that can be done, the child has what are known as retractile testicles. These are entirely normal and will usually descend spontaneously into the scrotum at puberty. If the testicles cannot be milked down, the child has true undescended testicles and will require surgery for correction. Boys who have retractile testicles will need yearly examinations because occasionally a child felt to have retractile testicles may develop undescended testicles as he gets older. Fortunately, this is uncommon.

The following answer originally appeared in Children's Development and Health:

Undescended testes or cryptorchidism is the inability of one or both testes to descend through the inguinal canal into the scrotal sac. In the majority of male infants, the testes will descend by the first year of life. Occasionally some boys will have a very active or sensitive cremasteric reflex that causes the testes to draw up when touched or stroked on the inner aspect of the thigh. Exposure to cold, such as during a diaper change, might trigger this same response. This sensitive reaction begins to fade after about 5 years of age.

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Response by:

Rama   Jayanthi, MD Rama Jayanthi, MD
Clinical Assistant Professor of Urology
College of Medicine
The Ohio State University