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After birth, one testicle normal, other seems pulled up. Should be concerned ?

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For my Cousins child after birth one of his testicle stayed in lower abdomen.After birth one of the testicle has been out like normal case and another is slightly pulled in.When the legs are folded towards stomach both of them are visible in the sack,but when legs are pulled up or when the child stands one of it gets pulled into abdomen.have you heard of any such condition and will it cause any problem for him in future? The child is now abt 4 years old and everything looks normal,so can this be ignored or any thing needs to be done.
Posted Mon, 21 May 2012 in Testicle Problems
Answered by Dr. Taher Kagalwala 2 hours later

If you can see both the testicles in the sac, it might be a good idea to actually feel them both by hand in the sac. If they are both there (the testicles are small, round and firm and move easily under the fingers), then nothing to worry about. If, however, one of the testicles keeps moving into the abdomen, and is not felt by the hand on most occasions, it calls for better insight into the problem. Testicles function properly only if they hang outside the abdomen because the higher body temperature inactivates the reproductive cells that eventually turn into sperms after adolescence. In fact, an XXXXXXX testis would have already lost most of its reproductive cells by the age of one.

Considering that the other testicle is normally present in the sac means that he can perform well and even have children in adulthood. However, the testicle that stays inside the abdomen is, for all practical purposes, sterile, and it may mutate into cancerous cells if not removed.

The prudent course of action would be: a) First confirm if both the testicles can be felt or not. b) If felt outside the abdomen, nothing to worry, but even so, get this confirmed by a pediatrician. c) If you cannot feel the testicle outside, go for a testis ultrasound examination under the advice of a good pediatrician or pediatric surgeon. d) If it is proved that one of the testicles is in the abdomen, go in for its removal by direct surgery or laparoscopy ONLY by a qualified pediatric surgeon/laparoscopist.

Hope this helps. Thank you for forwarding your query.

With warm regards,

= Dr. Taher
Above answer was peer-reviewed by
Follow-up: After birth, one testicle normal, other seems pulled up. Should be concerned ? 38 hours later
ThankYou Doctor
When I say into abdomen I actually meant it was just above the sack and at area behind the penis.Like I said earlier only on bending of legs towards stomach will they both come in sack.And one is normal (always in sack) and other is pulled in above sack.From here on all description i am providing is of problematic testis.
When felt with fingers it is tight and not freely moving like the other one.When the child stands ,the end of testis can be felt just beside the penis root,so basically in standing position its just behind the penis root(begins) in the cavity may be near the urethra.So basically it is in between the cavity of both legs or where penis originates and comes into sack only when the child bends his legs towards the stomach.In sleeping position it is pulled into body and cannot be felt.So looks like its tightly couple with some muscles of stomach or lower abdomen.

Can you now tell will it still be infertile and cause any issue in his later life?It does not trouble him(no pain),even then should we go for surgery?Are there anyways through excersise etc..that it can come back into sack?
Follow-up: After birth, one testicle normal, other seems pulled up. Should be concerned ? 3 minutes later
Also shed some light on the symptoms abt if it develops into cancerous cells.
Answered by Dr. Taher Kagalwala 13 hours later

Sorry to keep you waiting for a long time. I have read your question in detail, and I will once again say that even with a single functioning testis, a child will remain NORMALLY fertile in adulthood.

Having said this, it is now obvious to me that the second testis is also OUTSIDE the warm cocoon of the abdomen and should continue to function normally once the baby has grown into adulthood. A cancerous change in an externally located testicle is not something that WILL occur. Of course, anyone even with normally placed testicles can also develop cancer of the testicles, but this is a rare form of cancer in males.

With an undescended testicle, however, the chance of a cancerous change occurring is slightly, only slightly increased, and because the testicle is within the abdomen (in such cases), there might be no symptoms at all till the testicle is enlarged and causes discomfort or pain. That is why it is recommended that if a child has a testicle that has not fully come into the sac below, one must operate and BRING IT OUT EVEN IF IT IS ALREADY NON-FUNCTIONAL, so that if. Allah forbid, it undergoes a cancerous change, it will be detected easily.

I would, for the time being recommend that a) you show the child to a good pediatrician b) go for a testicular ultrasound examination to correctly pinpoint the location of both the testicles, and c) if a) and b) are normal, wait and do nothing for a few more months. If after the waiting period, the second testis has STILL NOT APPEARED in the scrotum, try consulting a pediatric surgeon.

I hope this helps.

With best regards,

Dr. Taher K
Above answer was peer-reviewed by
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