Dr Varinder Attri – Urologist, Andrologist and Laparoscopic surgeon

• Absence of either testis from its normal position in scrotum is called undescended testis.
• It is most common congenital abnormality (present at birth) found in male genitalia.

Classification

• Congenital – Undescended testis present since birth
• Acquired – testis which has migrated up that has been previously noted to be present in scrotum
• Location wise – sometimes the testis is found in its path of descent from abdomen into scrotum and hence can be Inguinal (groin) or Intra-abdominal. Sometimes testis can be present not in path of normal descent which is called  Ectopic testis.

Causes of undescended testis

• Developmental disorder of the gonads by either environment or genetic factors.
• Maternal smoking
• Premature birth

Effects of undescended testes

• Undescended testis of one side can affect the function of normally descended other testis also.
• Impaired semen parameters- sperm can be of low quality.
• Impaired fertility- difficulty in conceiving.
• Hypogonadism (testosterone deficiency)- male hormone can be deficient and leads to its symptoms.
• Tumors in the undescended testis – undescended testes, particularly intra-abdominal are more prone to get tumor in it.

Treatment

• Surgical treatment is mainstay of management.
• In infants and early age, surgical correction with bringing testis down into scrotum is done.
• In adults with intra-abdominal testis, and having normal opposite testis, orchiectomy is usually considered. However if both testes are intra-abdominal, surgical correction to bring testes down into scrotum is considered.