About 3 percent of male full term babies and 30 percent of premature and low birth weight babies are born with an undescended testicle. The testes develop in the unborn baby's abdomen during the mother's pregnancy. Normally, around the eighth month, they will descend into the sac (scrotum) that holds the testes at the base of the penis. When this does not happen, one or both testes will remain in the abdomen. In most cases, undescended testes will drop, without intervention, into the scrotum within the first year of life. This often occurs during the first three months. By age one, only 3 or 4 boys in 1,000 will still have the problem. They are usually not painful and urinating is not affected.

Signs to look for include:
* A small scrotum that appears to be undeveloped.
* The scrotum may look full on one side and empty on the other when only one testicle is affected.
* A twisted undescended testicle may cause pain in the groin or scrotum. If pain occurs, call your pediatrician immediately.

Testes that do not descend may in time degenerate or shrink. As a result, the normal supply of the male sex hormones is not produced. This can impair a boy's development at puberty. Body hair, musculature, voice deepening, and other normal male sex changes taking place at that time may be delayed. Some will be infertile. Sperm production is decreased in cases where one testicle is damaged and the other is normal and descended.

Medical care may include hormone therapy or surgery or both. Surgery is usually successful if done between 9 and 15 months. A child with the condition develops a higher than average risk of not being able to father children. There is also an increased risk of developing cancer of the testes even when they are brought down by surgery. All boys who have had an undescended testicle should be taught to examine their testes for lumps and other signs of cancer.

Any indication of absent, too small or too large testicles should be reported to your healthcare provider. Sometimes testicles are pulled up high into the scrotum or inguinal canal. Retracted testicles may be more easily felt after the child has sat in a tub of warm water, or when he is in a squatting position. If there is any doubt about the presence of both testicles, the child should be seen by a healthcare provider.

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