Undescended Testicle (Undescended testis) in Children

If your son’s testicle (testis) has not moved into the scrotum, early assessment is important. An undescended testis (cryptorchidism) is one of the most common conditions seen in baby boys, and treatment at the right age can help protect fertility and reduce future complications.

Quick answers for parents

What is an undescended testicle (undescended testis)? A testicle that has not moved into the scrotum after birth.

When should surgery be done? Usually between 6–12 months, and by 18 months at the latest if it has not descended naturally.
How long does surgery take? About 2 hours as a day surgery in most children.
Is recovery painful? Most if not all children go home on the same day after surgery. A child may experience discomfort over the wounds for 2 to 3 days. He can exercise and swim after 2 to 3 weeks.

What is an undescended testicle (undescended testis)?

Normally, a baby’s testicles develop inside the tummy (abdomen) during pregnancy and move into the scrotum before birth. An undescended testis occurs when one or both testicles stop somewhere along this path.

Signs parents notice

One side of the scrotum looks smaller or empty.
The testicle (testis) cannot be felt during bathing.
A doctor notices it during a routine examination.
The testicle seems to “disappear” after previously being in the scrotum.

Why early treatment matters?

Leaving an undescended testicle (undescended testis) untreated increases the risk of:

Reduced fertility later in life
Testicular cancer
Twisting of the testicle (torsion)
Injury from an abnormal position

Performing surgery within the recommended age helps improve long-term outcomes.

When should my child see a paediatric surgeon?

Arrange an assessment if:

the testicle has not descended by 6 months,
only one testicle is visible,
the testicle disappears permanently,
or there is pain or sudden swelling.

Do children need an ultrasound?

An ultrasound is usually not needed. In selected patients, an ultrasound helps to determine if an impalpable testis is in the groin.

Ultrasound is accurate in only up to 76% of patients, false positives include the gubernaculum, lymph node and scar tissue.

A careful physical examination by an experienced paediatric surgeon guides the management. An examination under anaesthesia is the most accurate in diagnosis. When the testis is not palpable, laparoscopy is the gold standard to exclude an abdominal testis. When the testis is palpable, surgery for an undescended testis (orchidopexy) is performed.

Surgery for an undescended testis: Orchidopexy or Orchidectomy

Orchidopexy is the operation used to move the testis into the scrotum and secure it there.

Orchidectomy is the operation to remove non viable testicle remnant tissue. This is to prevent cancer change.

What happens during surgery?

Your child receives a general anaesthetic and is examined carefully to locate the testis.
If the testis is palpable in the groin, a small incision is made in the groin skin crease.
The testicle is carefully freed.
A small incision is made in the scrotum. The testis is positioned inside the scrotum.
Small dissolvable stitches are used.

6. For a non-palpable testis, laparoscopic (keyhole) surgery is used to enter the tummy (abdomen).

7. Depending on the location of the testis in the abdomen, a single staged or first (of 2 stages) stage orchidopexy is performed.

Recovery after orchidopexy

Most of my patients:

go home on the same day after surgery,
take pain relief for 2 to 3 days,
walk normally on the same day,
avoid exercise and swimming for around 2 weeks.

Estimated cost of surgery for an orchidopexy

The estimated cost for an uncomplicated surgery for an undescended testicle (orchidopexy) take reference from the Ministry of Health Singapore Fee Benchmark. This day surgery procedure at the Paediatric Surgery and Urology International Ambulatory Surgical Centre (ASC) operating theatre costs SGD 4976.00 for the ASC, SGD4959.50 for the Surgeon’s Fee, SGD2180 for the Anaesthetist Fee, 457.80, SGD 457.80 for each of the doctor’s attendance fees. This is a total estimated cost of SGD13,031.11 This is lower than the fees in the private hospitals and saves inpatient fees of up to SGD2526, when the patient is discharged as a day surgery procedure. Reference: https://www.moh.gov.sg/managing-expenses/bills-and-fee-benchmarks/cost-financing/tosp-sh802t-bill-information/

Frequently Asked Questions (FAQ)

Can an undescended testicle come down on its own?

Yes, but mostly during the first 3–6 months. After six months, spontaneous descent becomes unlikely.

Is it painful?

Usually not. Most babies are otherwise well.

Will my child be infertile?

Many boys have normal fertility, especially when treated early.

Can adults have an undescended testicle?

Yes, although it should ideally have been treated in childhood.

Is a retractile testicle the same thing?

No. A retractile testicle can usually be brought into the scrotum during examination and only needs monitoring.

What is the success rate of an orchidopexy?

I have never had to revise or redo an orchidopexy for my patients. The literature reports success rates above 90% for palpable undescended testes.

Why choose a paediatric surgeon?

Children benefit from care tailored to their age, including:

child-friendly assessment,and family-centred recovery advice.
paediatric anaesthesia,
minimally invasive techniques when appropriate,

Book an appointment

If your son has an undescended testis or an empty scrotum, early assessment can help determine whether observation or orchidopexy is appropriate.

+6563592679

+6587727527

[email protected]

Share if you like this post

If you have other enquiries on children’s surgical conditions, feel free to contact us

Enquire