With a small number of boys one or both testicles are missing from the scrotum. If the boy is more than one year old and the testicle is still not to be found you should contact the doctor since the boy is in the risk of becoming sterile. Treatment of a testicle missing from the scrotum is either surgical or medicinal.
The testicles are developed in the abdominal cavity and usually travel down into the scrotum before birth. Therefore most boys have two testicles in the scrotum at birth. However, a testicle missing from the scrotum is one of the most common congenital afflictions.
With a few boys (10%), one or both testicles are missing at birth. This is usually because the testicle has not travelled down into the scrotum. With most of these boys, the testicle will travel down into the scrotum by itself during the first 6 to 12 months after birth. Only in very few cases (1%) a testicle will still be missing after 12 months.
With boys in the age of 5 to 9 years old, a muscle in the scrotum may pull the testicle up into the abdominal cavity. In those cases, the boy will at birth have two testicles in the scrotum but later one disappears from the scrotum – it has been pulled up into the abdominal cavity by the muscle. It is of no importance. When the boys enter puberty, the testicle drops to its place in the scrotum.
When a testicle is missing from the scrotum, there is an increased risk for low sperm count and testicular cancer. Grown men who are missing both testicles in the scrotum are usually unable to produce sperm and half of the grown men who are missing one testicle have a low sperm count. When treated, the sperm count improves significantly. Therefore a missing testicle should always be treated.
There is no consensus about at what age a missing testicle should be treated. You can choose between surgical and medicinal treatment. Most doctors recommend surgical treatment before the boy is 12 months old. With surgical treatment the missing testicle is located in the abdominal cavity and placed in the scrotum.
All newborn boys are examined by a doctor. The doctor examines, among other things, whether the testicles are in the scrotum. If one of the testicles are missing, the doctor makes another examination after 6 months and if the testicle has not travelled to the scrotum yet, the boy should be treated.