Undescended Testicle Surgery and Hormone Treatment
Treatment for the undescended testicle depends on the location of the testis.
Options for testicles felt in the groin area
Surgery to Treat Undescended Testicle
For testes that can be felt in the groin area, the usual recommendation is an operation called anorchiopexy or orchidopexy. This literally means "fixing the testis."
This surgery is almost always performed as an outpatient procedure. It is done through a small hernia incision in the groin and takes up to an hour and a half to perform. Recovery is generally very rapid and the outcome is usually good.
Hormone Treatment for Undescended Testicle
An alternative is hormonal treatment with HCG, a series of injections that stimulate the testicles to make hormones.
In a small number of boys, this treatment will result in permanent descent of the testicle. Hormonal treatment is sometimes recommended if the testis is very close to the scrotum and there is a good likelihood of success.
Options for testicles that cannot be felt
If the testicle cannot be felt by the doctor, it is called an "impalpable" testis (which simply means "cannot be felt"). Impalpable testes may be inside the abdomen, too small to feel, or they may be absent.
Surgery to Locate Testicles in the Abdomen
Unfortunately, there is no reliable x-ray that can tell us whether a testis is in the abdomen. Generally, surgery is required to make that determination.
The most accurate operation to locate these testicles is a laparoscopy, a procedure in which a telescope is placed into the abdomen through a small incision near the navel. The abdomen can be examined with a telescope, and the results may show:
- No testicle, in which case the operation is over.
- A small testicle in the groin, in which case a groin incision is made and the area is explored for a small testis, which must be removed.
- A testicle inside the abdomen, in which case an operation can be done to either remove the testis or move it into the scrotum. The operation to move high testicles into the scrotum is more difficult than for the testicles that are in the groin. Because of this, the success rates are lower for these high testicles.
UPMC pediatric urologists and others have been developing and refining the technique of laparoscopic orchidopexy, which has proven to be a safe and effective method for bringing these testicles down. Laparoscopic orchidopexy is an operation that can be done by experienced pediatric laparoscopic surgeons.
Options for adults
Options are different for adults with an undescended testicle. Bringing the testicle down to the scrotum will probably not affect fertility and, therefore, an undescended testicle might simply be removed.
The ages of higher risk for testicular cancer are from 18 to 40, with most occurring in younger men. For this reason, and due to the increased risk of anesthesia in older patients, it has been recommended that nothing be done about these testicles after age 32. This is an individual consideration and you should consult with your physician.
Treatment at UPMC
To schedule an appointment, call 412-692-4100 between 9 a.m. and 5 p.m., Monday through Friday.
Department of Pediatric Urology at UPMC Children's Hospital of Pittsburgh
Call 412-692-5400 between 9 a.m. and 5 p.m., Monday through Friday, to schedule an appointment.