Undescended Testicle in Babies: What Parents Should Know
An undescended testicle is common in baby boys. See when it is checked, how often it drops by itself, when surgery is advised and the signs needing a doctor.
Babylove Editorial Team
Published
5 min read
In this guide
An undescended testicle is one that hasn’t moved down into the scrotum by the time a baby boy is born. It is common, particularly in boys born early, and it is painless. In many babies the testicle drops by itself in the first few months. If it hasn’t come down by around 6 months, it is unlikely to move on its own, and doctors usually recommend a small operation (orchidopexy), typically between about 6 and 18 months of age, to bring it into the scrotum.
Here’s how it is picked up, what happens next, and what to watch for at home.
What is an undescended testicle?
Testicles develop inside the tummy before birth and gradually move down into the scrotum, usually in the last months of pregnancy. Sometimes one or both stop partway, often in the groin. Doctors call this cryptorchidism or undescended testis.
The American Academy of Pediatrics (AAP) says about 1 to 3% of full-term boys have an undescended testicle at birth. It is much more common in premature babies: around 30% of low-birthweight boys, and nearly all very-low-birthweight boys. Our guide to premature babies and the NICU covers other checks preterm babies have.
It usually affects one side, but sometimes both.
How and when it’s checked
Your baby’s testicles are checked during the newborn examination in hospital, and again at routine reviews in the first year. The NHS notes it is usually picked up during the newborn physical examination in the first few days. Doctors check the genitals at well-baby visits, so mention it if you are unsure. Our guide to baby checkups in the first year explains what each visit covers.
Undescended, retractile or missing?
| Term | What it means | Usual approach |
|---|---|---|
| Undescended | The testicle has stopped on its way down, often in the groin, and can’t be brought fully into the scrotum | Watch for a few months; refer to a surgeon if it hasn’t come down |
| Retractile | The testicle has come down but a muscle reflex pulls it up, for example when your baby is cold or upset. It can be gently guided back into the scrotum. | Often needs no surgery, but should be checked as the child grows |
| Not palpable | The testicle can’t be felt at all; it may be higher up inside the tummy, or rarely absent | Specialist assessment, sometimes with further tests or keyhole surgery |
If neither testicle can be felt, doctors usually arrange a prompt specialist review, as this occasionally points to another condition that needs checking.
Will it come down by itself?
Often, yes. The NHS says the testicles often move down naturally in the first few months after birth, and the AAP says this usually happens by about 6 months of age. After that point, it is unlikely to happen on its own.
In the meantime, there’s nothing you need to do at home. It isn’t caused by anything during pregnancy that you could have prevented, and it doesn’t hurt your baby.
When surgery is recommended
If the testicle hasn’t come down by around 6 months, your baby will usually be referred to a paediatric surgeon or paediatric urologist. In Singapore, this can be at KKH, NUH or a private paediatric surgical practice. Guidance on timing varies slightly between countries:
- The NHS advises referral if one testicle hasn’t come down by about 4 to 5 months, and sooner if both are affected. It says the operation is usually done when the child is around 1 year old.
- The AAP advises that treatment should start once the child is 6 months old if the testicle hasn’t come down, and that surgery should ideally be done within the first 18 months.
Your surgeon will recommend timing based on your son’s age, health and the position of the testicle.
What is orchidopexy?
Orchidopexy is an operation under general anaesthetic to bring the testicle down and fix it in the scrotum. It is usually done through a small cut in the groin, or by keyhole surgery if the testicle is higher up. The NHS describes it as safe and effective. Many babies have it as day surgery, though this depends on the hospital and your child.
Ask your surgeon about costs and payment options before the operation. Medically necessary surgery for Singapore Citizens and PRs may be partly payable through MediSave and MediShield Life, depending on the setting and ward class. Check with the hospital’s financial counsellor.
Recovery at home
- Your baby may be sore for a few days; your doctor will advise on pain relief
- Keep the wound clean and dry, and follow instructions on bathing
- Avoid straddle toys, walkers and ride-on toys for the period your surgeon advises
- Go to a follow-up appointment to check the testicle has stayed in place
- Contact the hospital if the wound becomes red, swollen or oozes, or your child has a fever
Why it’s treated
The scrotum keeps the testicles slightly cooler than the rest of the body, which helps them develop normally. The AAP explains that surgery aims to reduce the risk of later hormone and fertility problems, and of testicular cancer, which is slightly higher if a testicle stays undescended. A testicle in the scrotum is also easier to examine as your son grows.
An undescended testicle can occasionally come with an inguinal hernia, a bulge in the groin. Your surgeon will check for this and may repair it in the same operation.
Later, when your son is older, teach him to check his testicles regularly, especially if he had an undescended testicle.
Signs that need a doctor urgently
See your GP or paediatrician, not A&E, if a testicle that was in the scrotum seems to have moved up as your son grows, or you’re simply unsure whether both are in place.
The bottom line
- An undescended testicle affects about 1 to 3% of full-term boys and many more premature boys
- It is checked at birth and at early baby reviews
- Many come down by themselves in the first few months; after about 6 months that’s unlikely
- Surgery (orchidopexy) is usually done between about 6 and 18 months, often around the first birthday
- Sudden scrotal pain or swelling is an emergency
Read more on the NHS undescended testicles page, or browse our newborn care hub. For everyday nappy-time care, see our newborn checklist.
Is an undescended testicle painful for my baby?
No, an undescended testicle itself isn’t painful. Sudden pain, swelling or redness in the groin or scrotum is different and needs emergency care, as it can be a twisted testicle or a trapped hernia.
Can an undescended testicle come down on its own?
Often, yes, usually within the first few months. If it hasn’t come down by about 6 months, it is unlikely to happen by itself and your baby will usually be referred to a surgeon.
At what age is surgery done for an undescended testicle?
Mainstream guidance is usually between about 6 and 18 months, often around the first birthday. Your paediatric surgeon will advise on timing for your son.
Will my son be able to have children?
Many boys treated for an undescended testicle go on to have children, and the outlook is generally better when only one side is affected. Treating it early aims to protect future fertility and hormone function, so ask your surgeon about your son’s situation.
This article is for general information and does not replace advice from your doctor, midwife or paediatrician. Spotted something out of date? Tell us.
