Undescended testicles

Undescended Testicles in Grand Rapids, Michigan

Testicles (testes) are male sex glands that produce sperm and testosterone. Typically, both testicles are located in the scrotum. Undescended testicles (also called cryptorchidism) means that one or both testicles are missing from the scrotum and are instead located higher up in the groin or inside the lower abdomen.

In Grand Rapids and across Michigan, undescended testicles are a common concern discussed at newborn and infant checkups with pediatricians at Spectrum Health, Trinity Health Grand Rapids, Metro Health, and other local clinics.

How Common Are Undescended Testicles?

About 5% of all boys are born with at least one undescended testicle.
In full-term babies, undescended testes occur in about 1 in 20 to 1 in 100 newborns.
In premature babies, up to 50% may have undescended testicles at birth.
Low birth weight (especially under 2.3 kg) increases the risk significantly.

In roughly half of affected newborns, the testicle descends into the scrotum on its own within the first 3 months of life. Because many Grand Rapids babies are born in large hospital systems like Spectrum Health Butterworth Hospital and Trinity Health Grand Rapids, this condition is usually picked up early through routine newborn exams.

If the testicle is still undescended at 3 months of age, your baby should be seen by a pediatric surgeon or pediatric urologist.

Undescended vs Retractile Testicles

It is important to distinguish undescended testicles from retractile (retractable) testicles:

Undescended testicles
- Not located in the scrotum.
- Usually found in the groin or lower abdomen.
- Do not move down into the scrotum on their own after 3–6 months.
- Typically require surgery.
Retractile testicles
- Normally housed in the scrotum.
- Can move up temporarily into the groin, especially in cold weather (common in Michigan winters) or when the child is anxious.
- Usually return to the scrotum and stay there most of the time.
- Do not usually need treatment as long as they remain in the scrotum before puberty.

If you live in Grand Rapids, your child’s pediatrician at Spectrum Health, Metro Health, Mercy Health, or a local family practice can help determine whether a testicle is retractile or truly undescended.

Other Names for Undescended Testicles

You may hear different medical terms used:

Cryptorchidism – medical term for undescended testicles
Empty scrotum – when one or both sides of the scrotum appear flat or empty
Monorchism – only one testicle is present in the scrotum

A boy with undescended testicles will have an empty scrotum on one or both sides. The condition is usually painless, and urination is not affected.

How Testicles Normally Develop and Descend

The testicles form inside the abdomen of a male fetus. Between about 25 and 35 weeks of pregnancy, the baby’s testicles normally:

Move down through small channels in the lower abdomen called the inguinal canals
Settle into the scrotum

In most cases of cryptorchidism, only one testicle is affected. In about 1 in 10 cases, both testicles are undescended (bilateral undescended testes).

Why Premature and Low Birth Weight Babies Are at Higher Risk

Premature babies may be born before the testicles have had time to complete their descent.
Low birth weight babies (especially under 2.3 kg) have a higher rate of undescended testicles.
Nearly 100% of male babies weighing under 907 g are born with undescended testicles.

Because West Michigan has cold winters, regular well-baby checks at Grand Rapids pediatric practices are especially important—cold can make testicles retract temporarily, which can confuse parents. Pediatricians are trained to examine the testicles in a warm, relaxed setting to get an accurate assessment.

Health Risks Linked to Undescended Testicles

Undescended testicles are linked to several potential health problems, especially if not treated early.

1. Inguinal Hernia

A boy with undescended testicles has an increased risk of an inguinal hernia (a bulge in the groin area where abdominal contents push into the inguinal canal).
Hernias are more common in premature infants, which Grand Rapids NICUs at Spectrum Health and Trinity Health regularly monitor.

2. Infertility and Reduced Sperm Production

Testicles are located in the scrotum because sperm production requires a temperature a few degrees lower than body temperature.

If a testicle remains in the abdomen or groin, it is exposed to higher temperatures.
Undescended testicles that are not brought into the scrotum from a young age will not produce sperm normally.
Even after surgery, men who had undescended testicles in childhood have higher rates of infertility than the general population.
About 10% of males who undergo surgical correction may have reduced fertility later in life.

3. Increased Risk of Testicular Cancer

Males with a history of undescended testicles have a 5–10 times higher risk of developing testicular cancer than other males.
This risk may remain even after corrective surgery, especially if surgery is delayed beyond early childhood.
Testicular cancer most often occurs between ages 25 and 40.

For boys in Grand Rapids who had undescended testicles, doctors at local urology and oncology clinics typically recommend regular testicular self-exams starting in the teen years and periodic clinical exams.

4. Testosterone (Androgen) Deficiency

Having two undescended testes increases the risk of testosterone deficiency later in life.
Low testosterone can affect:
- Puberty and growth
- Muscle mass and strength
- Bone health
- Mood and energy

5. Trauma and Injury

An undescended testicle located in the groin is more exposed to injury from bumps or direct blows than a testicle protected in the scrotum.

6. Emotional and Self-Image Concerns

An abnormal-looking scrotum or missing testicle can affect a boy’s self-confidence and body image, especially in later childhood and adolescence.
Pediatric providers in Grand Rapids often work with local child psychologists or counselors if body image concerns arise.

Acquired Undescended Testicles (Acquired Cryptorchidism)

Sometimes, a boy’s testicles are in the scrotum at birth and during early infancy, but move back up into the groin later on. This is called acquired undescended testicles or acquired cryptorchidism.

How Does This Happen?

Each testicle is attached to the body by a structure called the spermatic cord.
If the spermatic cord does not grow as quickly as the rest of the child’s body, it may become relatively short.
The short cord can gradually pull the testicle out of the scrotum and into the groin.

When Can Acquired Undescended Testicles Occur?

Typically between ages 1 and 10 years.
It can also occur in boys who were treated for undescended testicles as infants.
Up to 50% of boys who are treated for undescended testicle as a small infant may develop acquired undescended testicles later in childhood.

Because this can develop over time, Grand Rapids pediatricians and family doctors usually check boys’ testicles again:

At well-child visits, especially around school entry and during the elementary school years.
During sports physicals and adolescent checkups.

Diagnosis of Undescended Testicles in Grand Rapids

When Is the Diagnosis Made?

Newborn period: Pediatricians examine the scrotum shortly after birth at hospitals like Spectrum Health Butterworth or Trinity Health Grand Rapids.
3 months of age: If the testicle has not descended by 3 months, the diagnosis of undescended testicle is usually made, and a referral to a pediatric surgeon or pediatric urologist is recommended.

Physical Examination

The main tool for diagnosis is a careful physical exam.
The doctor will gently feel the scrotum, groin, and lower abdomen to:
- Confirm whether each testicle is present in the scrotum.
- Try to locate a testicle that may be in the groin or inguinal canal.
In some cases, the missing testicle can be felt in the lower abdomen or groin.

Ongoing Checks for Acquired Undescended Testicles

Your child’s GP or pediatrician in Grand Rapids should check for acquired undescended testicles:

Around the time your child starts school, and
Periodically up to about 10 years of age.

When Parents Should Seek Medical Advice

See your child’s doctor or a Grand Rapids pediatric clinic if:

You cannot see or feel one or both testicles in the scrotum when your child is:
- Relaxed and warm (for example, in a warm bath or after a warm shower).
Your older child or teen cannot feel one or both testicles in his scrotum.
You notice a new change, such as a testicle that was once clearly in the scrotum but now seems to be missing or higher up.

If needed, your doctor may refer you to a pediatric urologist at Spectrum Health, Trinity Health Grand Rapids, or Metro Health for further evaluation.

Treatment: Surgery for Undescended Testicles

Ideal Timing for Surgery

The best time for surgery is usually when the child is between 6 months and 1 year old.
Research suggests that future sperm quality in the affected testicle is worse if the condition is corrected after age 2.
However, surgery can still be beneficial later, especially in cases of:
- Acquired undescended testicles
- Boys who were not diagnosed or referred earlier

Name of the Procedure: Orchidopexy

Surgery to move the testicle into the scrotum and secure it there is called orchidopexy (or orchiopexy). This procedure is commonly performed by pediatric surgeons and pediatric urologists at major Grand Rapids hospitals.

How Orchidopexy Is Performed

While details may vary slightly by hospital, the general steps include:

General Anaesthetic
- Your child is given a general anesthetic, so he will be asleep and feel no pain during the operation.
Groin Incision
- The surgeon makes a small incision in the groin to locate and access the testicle in the inguinal canal or lower abdomen.
Freeing the Testicle
- The testicle is gently brought out of the inguinal canal.
- The spermatic cord (which connects the testicle to the body) is:
  - Carefully straightened (“unkinked”)
  - Gently stretched to its full length
- Any obstructive tissue that prevents the testicle from reaching the scrotum may be cut away.
Scrotal Incision
- A second small incision is made in the scrotum.
Placing and Securing the Testicle
- The testicle is moved down into the scrotum.
- It is stitched securely into place to prevent it from moving back up.
Closing the Incisions
- All incisions are closed with sutures (stitches), which may dissolve on their own.

Most boys go home the same day or after a short stay, depending on hospital protocols and the child’s overall health.

When the Testicle Cannot Be Found (Vanished or Absent Testicle)

In about 5% of cases, surgeons cannot find the missing testicle during surgery.

It is thought that the developing testicle may have died in the womb because of an interrupted blood supply.
This is sometimes called a vanished testicle or absent testicle.
Vanished testicle can be associated with other urinary or reproductive tract abnormalities, such as:
- Abnormal blood vessel networks
- Problems with the vas deferens (the tube that carries sperm)

If this occurs, your child’s surgeon and pediatrician in Grand Rapids will discuss:

Whether any further imaging or testing is needed
Long-term monitoring
Possible options in adolescence (for example, a testicular prosthesis for cosmetic reasons, if desired)

Possible Problems Associated with Undescended Testicles

Boys with undescended or previously undescended testicles may experience:

Poor self-image and reduced confidence
- Concerns about appearance, especially during puberty
Inguinal hernia
- Abnormal bulging in the groin
Trauma
- Increased risk of injury to a testicle located in the groin
Infertility or reduced fertility
- Particularly if both testicles were undescended or if surgery was delayed
Testosterone deficiency (androgen deficiency)
- More likely when both testicles are affected
Increased risk of testicular cancer
- Even after surgery, though early correction and regular monitoring may help reduce risk

Local pediatricians and urologists in Grand Rapids can coordinate long-term follow-up and, when needed, refer to endocrinologists, fertility specialists, or mental health professionals.

Local Grand Rapids & West Michigan Resources

If you are concerned about undescended testicles or your child’s genital development, you can seek help from:

Your GP or Family Doctor
Many family practices in Grand Rapids can provide initial assessment and referral.
Pediatrician
- Spectrum Health Helen DeVos Children’s Hospital pediatricians
- Trinity Health Grand Rapids pediatric clinics
- Metro Health and Mercy Health pediatric practices
Pediatric Urologist or Pediatric Surgeon
- Available through major hospital systems in Grand Rapids for specialized evaluation and orchidopexy.
Kent County Health Department
- Can provide guidance on local pediatric services and referrals, especially for families needing assistance with insurance or access to care.
Grand Rapids Public Health and Community Clinics
- Community health centers may help coordinate care and connect families to pediatric specialists.

If you are unsure where to start, calling your child’s primary care office or the Kent County Health Department is a good first step.

Key Points About Undescended Testicles

Premature and low birth weight babies are at increased risk of undescended testicles.
If a testicle is still undescended at 3 months, your baby should see a pediatric surgeon or pediatric urologist.
Surgery (orchidopexy) is the best treatment and is usually recommended between 6–12 months of age.
Even after corrective surgery, there remains an increased risk of testicular cancer, especially if surgery is delayed.
In a small number of cases, the testicle may have died before birth due to interrupted blood flow, leading to a vanished (absent) testicle.
Regular checkups with a Grand Rapids pediatrician or family doctor are essential to detect undescended or acquired undescended testicles early and arrange timely treatment.