Undescended Testicle (Cryptorchidism) in Babies
Content reviewed against published AAP, NIH, NHS guidelines
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An undescended testicle (cryptorchidism) occurs when one or both testicles have not moved down into the scrotum by birth. It is the most common genital abnormality in baby boys, affecting approximately 3-5% of full-term and up to 30% of premature boys. Many undescended testicles descend spontaneously by 3-6 months of age. If still undescended by 6 months, surgical correction (orchidopexy) is recommended by age 12-18 months to preserve fertility and reduce cancer risk.
Key takeaways
- An undescended testicle (cryptorchidism) occurs when one or both testicles have not moved down into the scrotum by birth.
- Most common cause: True undescended testicle (cryptorchidism — stopped along descent path)
- Emergency: Acute pain and swelling in groin where undescended testicle is located (torsion of undescended testicle)
- Home care: Check for testicles during warm bath (cremasteric reflex relaxes in warmth, making testicles easier to find)
Possible Causes
When to Seek Help
Emergency — Call 911 or go to ER:
- Acute pain and swelling in groin where undescended testicle is located (torsion of undescended testicle)
- Bilateral undescended testicles in newborn with ambiguous genitalia (disorder of sex development)
Urgent — See doctor today:
- Painful, tender groin lump in child with known undescended testicle
- Sudden disappearance of previously descended testicle with pain
- Bilateral undescended testicles with other anomalies (urgent genetic/endocrine evaluation)
Same-day appointment:
- Newly noticed empty scrotum (parent concern about undescended testicle)
- Previously descended testicle no longer palpable (ascending testicle)
- Undescended testicle at 6 months — needs surgical referral planning
Monitor at home:
- Known undescended testicle in infant under 6 months (may still descend spontaneously)
- Retractile testicle (goes up but can be brought down into scrotum — normal variant)
- Post-orchidopexy follow-up (checking position and growth)
- Premature infant with undescended testicle — monitor for descent as baby reaches term equivalent
By Age
0-2 months
Normal: Testicles may not be easily palpable in newborns due to small size and active cremasteric reflex. One testicle may be lower than the other (normal). Testicles may retract during crying or when cold. Premature babies commonly have undescended testicles that descend in the first months.
Worry if: Testicle not palpable in scrotum at birth (will be noted on newborn exam). Both testicles absent (needs evaluation for disorders of sex development). Scrotal asymmetry noted by parents. Empty scrotum on one or both sides.
2-6 months
Normal: Many undescended testicles that were not palpable at birth will descend spontaneously by 3-6 months. Retractile testicles (move up and down) are normal and do not need treatment.
Worry if: Testicle still not palpable in scrotum by 4-6 months. Groin lump (testicle stuck in inguinal canal). Bilateral absence (both testicles not descended).
6-12 months
Normal: If testicle has descended by 6 months and remains in scrotum, no further concern. Retractile testicle that can be manually moved into scrotum and stays briefly is normal variant.
Worry if: Testicle not descended by 6 months (unlikely to descend spontaneously now — surgical referral needed). Testicle that was previously descended but no longer palpable (ascending testicle). Painful groin lump (incarcerated hernia often coexists with undescended testicle).
1-3 years
Normal: Retractile testicles are common in toddlers — testicle pops up during examination or bathing but can be gently guided into scrotum. This is a normal variant that resolves with puberty.
Worry if: Previously descended testicle now consistently absent (acquired/ascending undescended testicle — needs referral). Undescended testicle not yet surgically corrected by age 18 months. Pain or swelling in groin where undescended testicle sits.
Home Care
- Check for testicles during warm bath (cremasteric reflex relaxes in warmth, making testicles easier to find)
- A retractile testicle (one that moves up and down but CAN be in the scrotum) is NORMAL and needs no treatment
- Do NOT try to force the testicle down — this does not help and may cause pain
- Attend all scheduled follow-up appointments — timing of surgery matters for long-term outcomes
- After orchidopexy surgery: follow surgeon instructions, expect some swelling for a few days
- Keep surgical site clean and dry, give prescribed pain medication
- Know that surgery (orchidopexy) is recommended by 12-18 months if not descended by 6 months
- Undescended testicle has increased lifetime risk of testicular cancer — teach testicular self-exam when older
- Hormonal treatment (hCG or GnRH) is no longer routinely recommended due to low success rates
Frequently asked questions
What causes undescended testicle (cryptorchidism)?
When is this an emergency?
What can I do at home?
When should I call the doctor?
Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Symptoms
Bottom line
Most cases of undescended testicle (cryptorchidism) in babies are not emergencies. However, seek immediate care if acute pain and swelling in groin where undescended testicle is located (torsion of undescended testicle).
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.