Hearing at your son’s newborn check that “one testis has not come down yet” can be unsettling, especially in the tired first days after birth. The good news is that an undescended testis is one of the more common findings in baby boys, it is usually picked up early, and there is a well-established plan for managing it. This guide explains what an undescended testes diagnosis in a baby means, how doctors check it, why they often wait before acting, and when surgery is usually considered.
This is general information, not medical advice. Your child’s doctor, polyclinic or paediatric surgeon will advise based on your son’s own examination. HealthHub and the hospital that follows up your baby are good sources of reliable local information.
What an Undescended Testis Is
Before birth, the testes develop inside the baby’s abdomen and gradually move down into the scrotum, usually in the later part of pregnancy. In some boys, one or both testes stop partway along this path. The medical term is cryptorchidism.
A few points help put this in context:
- It is more common in babies born early, because the testes may not have finished descending before birth.
- It can affect one side or both sides. One side is more common.
- The testis may be somewhere along the normal path, often in the groin, or occasionally somewhere unusual, or in rare cases it may not be found at all.
Undescended testes are generally not painful for the baby, and they do not affect day-to-day care such as bathing, nappy changes or feeding.
How It Is Detected
Most cases are found during routine checks, so parents usually do not need to look for it themselves.
- Newborn examination. The doctor checks the scrotum before your baby leaves hospital.
- Early follow-up visits. Checks at your baby’s paediatrician or polyclinic visits in the first months include the genitals. Findings are often recorded in your child’s health booklet.
- Later checks. Occasionally a testis that seemed normal at birth is noticed to sit higher later. If you are unsure, mention it at the next visit.
Doctors also distinguish an undescended testis from a retractile testis. A retractile testis has descended normally but is pulled up temporarily by a reflex muscle, often when the baby is cold or upset. It can usually be guided gently back into the scrotum during an examination and stays there for a while. This is generally considered a normal variation, although doctors may still review it over time.
Imaging such as ultrasound is not always needed. A careful physical examination by an experienced doctor is often the main way to assess it, and the doctor will explain if any test is useful for your son.
Watchful Waiting in the First Months
Many undescended testes come down on their own in the first few months after birth. For this reason, doctors commonly recommend a period of watchful waiting rather than treating straight away.
During this time:
- Keep the follow-up appointments you are given, even if your baby seems perfectly well.
- Note what you observe, for example if you see both testes in the scrotum during a warm bath.
- Ask your doctor at what age a referral to a paediatric surgeon would be made if the testis has not descended.
If the testis has not descended by around the age of six months, spontaneous descent becomes much less likely, and doctors usually refer to a paediatric surgeon. Your own doctor will advise the right timing for your son.
| Situation | What usually happens | What parents can do |
|---|---|---|
| Found at birth, baby otherwise well | Re-examined over the first few months | Attend follow-ups and note observations |
| Still undescended at around six months | Referral to a paediatric surgeon | Ask about surgery timing and what to expect |
| Retractile testis | Monitored, as it is usually a normal variation | Mention any change at routine checks |
| Testis not felt at all | Further assessment by a specialist | Ask what tests or procedures are planned |
Why Treatment Matters and When Surgery Happens
If a testis does not come down by itself, surgery is generally recommended. The operation is called orchidopexy. The surgeon moves the testis into the scrotum and fixes it in place.
Doctors recommend treatment because a testis that stays outside the scrotum is exposed to higher body temperature, which can affect its development over time. Correcting the position is also linked with better long-term outcomes and makes it easier to examine the testis later in life. An undescended testis may also come with an inguinal hernia, which the surgeon can often repair at the same time.
On timing, international guidance has generally favoured surgery in the first year or so of life, often between around six and 18 months, rather than waiting until later childhood. Your paediatric surgeon will recommend a timing based on your son’s situation.
What parents commonly want to know:
- It is usually a day surgery done under general anaesthesia, often through a small cut in the groin and sometimes a second small cut in the scrotum.
- If the testis cannot be felt, the surgeon may use keyhole (laparoscopic) surgery to locate it.
- Recovery is usually quick in babies. You will be given wound care instructions and advice on pain relief, bathing and activity. Follow these instead of general advice online.
- Follow-up visits check that the testis stays in position and is growing.
Ask the surgical team about costs and how MediSave or any insurance coverage applies, as these depend on the hospital and your policy. Check with the hospital’s billing office and your insurer.
Supporting Your Son as He Grows
For most boys, a successfully treated undescended testis becomes a small part of their medical history. A few helpful habits:
- Keep records of the diagnosis, surgery and follow-ups in your child’s health booklet or HealthHub.
- As your son grows older, a doctor may teach him how to check his testes as part of normal health habits.
- If you notice sudden pain, swelling or redness in the groin or scrotum at any age, seek medical attention promptly, as this needs urgent assessment.
If you have questions about other conditions affecting baby boys, our guide to circumcision for baby boys in Singapore covers a separate topic parents often ask about, and Kawasaki disease signs is another useful read on spotting when a child needs a doctor. For your son’s undescended testis, your doctor and paediatric surgeon remain the best people to guide each step.
Official sources: HealthHub
Further reading: Hydrocele and Inguinal Hernia in Baby Boys: What Parents Should Know