Overview of Undescended Testis

Undescended testis (UDT) is a common congenital problem. On an average, 2-3 out of 100 boys at birth have UDT (that amounts to 2-3 % of all boys). Of these, the majority have UDT on one side (with the other side normal), but 15-20% have UDT on both sides.

In case of UDT with normal penis, no further tests are necessary. However, if the UDT is associated with hypospadias, micropenis or other penile abnormalities, further investigations may be necessary

In some cases, UDT at birth may reach the scrotum spontaneously by 3-6 months of age. In such children, no further treatment is necessary. However, if the testis does not come down by 6 months, surgery is advised to bring it down. If the testis is palpable (can be felt in the groin), it can be brought down by surgery at the groin itself. A more recent technique of single scrotal incision orchiopexy gives excellent cosmetic result (see Figure below).

In case of a UDT that is not felt, laparoscopy is the best option, both for locating the testis & therapeutic purposes.

A 1.5 years old boy was brought with absent testis in bilateral scrotum. 

A clinical examination revealed left testis to be retractile (which goes up but can be brought down- a normal phenomnenon in young age group) and right testis to be a undescended testis. 
This testis could not be felt on clinical examination. 
Parents were explained and the child was taken up for Laparoscopy for diagnosis and treatment.
Laparoscopy showed the testis to be present inside the abdomen. This was mobilized and brought down to normal position with laparoscopy. 

Fig 1: Clinical Picture Showing Empty Scrotum

Fig 2: Laparoscopic Orchiopexy - right testis brought down

Fig 3: Laparoscopic view showing right testis inside abdomen