Testicular Absence in Infants: Surgical Options and Outcomes

Absence of testicles in the scrotum?

My son is currently one year old, and there are no testicles in his scrotum.
After a hospital examination, they said, "It's not cryptorchidism; they are located nearby and can be surgically moved to the correct position." They also mentioned that surgery is not necessary, and he will just be different from others.
Since I couldn't find relevant information online, I would like to ask: if we don't opt for surgery, will the testicles really not return to the scrotum? If he undergoes surgery at such a young age, is there a chance they could shift again?

Zhu, 30~39 year old female. Ask Date: 2016/01/22

Dr. Li Xinyi reply Urology

It sounds like there shouldn't be any issues.
As long as the testicles are not in the abdominal cavity and can develop normally, there is a chance for gradual improvement.
However, it is still important to see a urologist for a thorough examination to confirm the diagnosis and for follow-up.

Reply Date: 2016/01/22

More Info

Testicular absence in infants, particularly when it is not due to cryptorchidism (undescended testis), can be a concerning diagnosis for parents. In your case, it appears that your son has a testis that is not located in the scrotum but is instead situated in an adjacent area. The medical team has indicated that surgical intervention is an option to reposition the testis into the scrotum, but they also mentioned that it is not strictly necessary.
To address your concerns, let’s break down the situation:
1. Understanding Testicular Absence: In some cases, a testis may not descend into the scrotum due to various reasons, including anatomical anomalies or developmental issues. If the testis is located nearby but not in the scrotum, it may still be functional, but its position can affect fertility and increase the risk of complications such as testicular torsion or malignancy later in life.

2. Surgical Options: The surgical procedure to reposition the testis is known as orchidopexy. This surgery is typically performed to ensure that the testis is in the correct anatomical position, which is crucial for normal hormonal function and fertility as the child grows. The surgery is generally safe and has a high success rate.
3. Outcomes of Not Performing Surgery: If surgery is not performed, the testis may remain in its current position. While some children may not experience significant issues, there is a risk that the testis could become torsed (twisted), which can lead to pain and loss of the testis. Additionally, the testis may not develop normally if it remains outside the scrotum, potentially impacting fertility in the future.

4. Risk of Repositioning: After surgical intervention, there is a possibility that the testis could move back to its original position. However, this risk can be minimized with proper surgical techniques and follow-up care. Pediatric urologists typically monitor the position of the testis after surgery to ensure it remains in the scrotum.

5. Timing of Surgery: Performing surgery at a young age, such as one year old, is often recommended because the earlier the testis is positioned correctly, the better the outcomes for hormonal and fertility health. Delaying surgery may lead to complications that could have been avoided.

6. Consulting a Specialist: It is essential to have a thorough discussion with a pediatric urologist who specializes in this area. They can provide you with detailed information about the risks and benefits of surgery versus observation, tailored to your son’s specific situation.

In conclusion, while it is possible for the testis to remain in its current position without surgery, the potential risks associated with this decision should be carefully weighed against the benefits of surgical intervention. Consulting with a specialist will help you make an informed decision that is best for your child's health and future.

Similar Q&A

Undescended Testes: Impact on Fertility and Surgical Timing

Congenital cryptorchidism from infancy, which was not surgically addressed in a timely manner, may lead to infertility issues if surgery was only performed later, such as during military service. This condition can affect sperm production and hormonal function, potentially impact...

Dr. Xu Weikai reply Urology
HIME: Hello, 1. Is it unilateral or bilateral? 2. What type of surgery was performed? 3. Current condition of the testicles: size, shape, etc. Recommendation: The simplest approach is to go to a laboratory to check the semen for any issues. If necessary, additional endocrine test...

Understanding Testicular Absence: Causes, Concerns, and Treatment Options

Hello, doctor. I have a concern that has troubled me for a long time. I remember that when I was a child, I had one testicle that was absent, but at that time, I didn't understand it, so I didn't pay much attention. However, at some age, that missing testicle reappeared...

Dr. Fu Shizhang reply Urology
It is indeed possible that if the testes do not develop within the scrotum, it may affect their development. The testes are primarily responsible for the secretion of male hormones, which are closely related to the development of secondary sexual characteristics. Therefore, if th...

Understanding Cryptorchidism in Infants: When to Consider Surgery

Hello Doctor: On November 22, I took my baby to the hospital for vaccinations. During the pediatric check-up, I asked the doctor to examine my son's genitalia because I recently noticed that one of his testicles seemed to be missing. The doctor diagnosed it as cryptorchidism...

Dr. Zhao Yongkang reply Pediatrics
Dear Concerned Mother, 1. Generally, the recommended timing for surgery for cryptorchidism is when the child is about 9 to 15 months old. However, based on your description, if your child can feel the testicle during bathing, it may be a case of retractile testis. In this situat...

Understanding Cryptorchidism: Concerns and Next Steps for Your Child

My younger brother underwent surgery to remove a testicle, but after a few days, it was reported that it was missing again. The doctor mentioned it was a case of retractile testis, but now that he is almost two years old and it hasn't descended, we are concerned about its im...

Dr. Lin Yishou reply Pediatrics
Please quickly consult a pediatrician or a pediatric surgeon to recheck the position of the testicles.