Missing
testicle
Some people
have a testicle on only one side. On the other side, the testicle
is completely missing or it may be felt as a lump in the groin.
In either case, it is called ‘undescended testicle’.
How
undescended testicle occurs
Your testicles started to develop when you were a tiny fetus
(a few weeks after you were conceived). They began high inside
your abdomen, near the kidneys at the back. About 6 months before
you were born, they started to journey forwards and downwards
towards the groin. Meanwhile, your scrotum was developing ready
to receive them. About a month or two before birth, the testicles
normally complete the journey by descending into the scrotum.
In about
3–4% of boys, one testicle doesn’t make the journey
from the back of the abdomen to the scrotum. Instead, it becomes
stuck inside the abdomen or at the groin. This why it is called
‘undescended testicle’. No-one knows why it happens,
but it seems to be getting more common.
Most babies
with undescended testicle do not need any treatment –
in 3 out of 4 cases the testicle will come down naturally before
the baby is 3 months old. If not, the baby often has an operation
at about 18 months of age.
What
to do if you have only one testicle
If you are a teenager or an adult with an undescended testicle
you should definitely see your doctor. Your doctor should refer
you to a hospital specialist (urologist). There is no need to
feel at all embarrassed, because all doctors know this is a
problem that needs attention. There are at least three issues
that you will need to discuss with the urologist.
- Firstly,
an undescended testicle is slightly more likely to develop
cancer than a normal testicle. The risk is roughly 1 in 2,000.
(The risk of testicular cancer in all men is about 1 in 100,000.)
In fact, cancer of the testicle is almost always curable,
partly because men easily notice a lump on their testicle
and therefore it is caught at an early stage. But if the cancer
develops in a testicle that is hidden up in the abdomen, it
will be difficult to detect. A testicle that has become stuck
in the abdomen is unlikely to be producing sperm, so the urologist
may suggest that you have an operation to remove it, to prevent
it becoming cancerous in the future. This is a complicated
decision, which you will have to discuss in detail with the
urologist. It may depend partly on your age: cancer of the
testicle is most common in young men, so after the age of
about 32 years the risk of the operation may outweigh the
likelihood of getting cancer and it might be better to do
nothing.
- Secondly,
if you have only one testicle you may be worrying about fertility.
Although the undescended testicle probably isn’t doing
much, you need not be too worried because your other normal
testicle is likely to be producing many millions of sperms.
- Thirdly,
an undescended testicle is not firmly anchored, and can become
twisted on the tissues that surround it. This is called ‘torsion’.
Episodes of torsion are very painful. So if you have abdominal
pain as well as an undescended testicle stuck in the abdomen,
your doctor will need to consider the possibility of torsion.
- Fourthly,
if having an empty scrotum on one side bothers you, you can
ask the urologist about having an artificial implant to give
the appearance and feel of a normal testicle. These are either
silicone, or a silicone bag filled with saline (similar to
a breast implant).
Back to
Testicle problems main page or on
to next section
