The testicles are the male reproductive glands essential for fertility and producing all male (secondary sex) characteristics; they produce sperm and the male sex hormone, testosterone, from puberty through adulthood. During the males fetus' normal development, the testicles move from the adbominal cavity to their mature location in the scrotum, a pouch of skin suspended behind the penis.

In about two percent of full-term male infants and as many as ten percent of premature male infants, however, one or (more rarely) both testicles fail to migrate to the scrotum; such testicles are termed undescended; the condition, known as cryptorchidism, is usually accompanied by an inguinal hernia. Early treatment is important; an undescended testicle will not develop normally, possibly causing infertility and greatly increasing the long-term risk for testicular cancer appearing at age 30 or 40.

HOW DO I RECOGNIZE AN UNDESCENDED TESTICLE?
An undescended testicle does not usually cause pain, so it may not be noticed unless parents and physicians carefully examine the child's genitalia. Suspect an undescended testicle if the infant's scrotum appears flat and small rather than rounded by the two spherical lobes that indicate the presence of both testicles.

IS MEDICAL ATTENTION NECESSARY?
Yes. Medical attention is advisable because a failure of the testicle to move down into the scrotum increases the risk of complications, such as infertility. In many cases, the testicle will descend spontaneously before the infant reaches his first birthday; consequently, surgical treatment to preserve spermatic development and function usually is postponed until that age in the hopes that surgery will be unnecessary.

HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS AN UNDESCENDED TESTICLE?
Undescended testicles often are discoverd in the course of a medical examination at birth or during early infancy. The doctor will perform a careful physical examination to distinguish a true undescended testicle from other abnormalities causing testicular displacement. A retractile testicle, for example, is a normally descended testicle that has been pulled out of the scrotum by a strong reflex brought on by pain, cold, fear or other strong stimuli.

WHAT TREATMENTS ARE AVAILABLE?
Although some physicians try hormonal therapy first, surgical transfer of the testicles into the scrotum, known as orchidopexy or orchiopexy, is the standard treatment; associated hernias are corrected at the same time. Orchidopexy, if the child is otherwise healthy, is usually performed shortly after age one and allows the testicle the greatest chance for normal development. Hospitalization may not be necessary if the operation is performed in the morning. Within a day or two, the child should be ready to resume most normal activities.

GETTING HELP
Call your doctor if:

• Your infant's genitalia appear abnormal in any way

• Your infant's scrotum seems flattened or misshapened

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.