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Undescended (missing) testicle(s)

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 2–4% of boys, one testicle doesn’t make the journey from the back of the abdomen to the scrotum before birth. Instead, it becomes stuck inside the abdomen or at the groin. This is why it is called ‘undescended testicle’. No one knows why it happens. It is more common in premature babies.

Most babies with undescended testicle do not need any treatment – in 2 out of 3 cases the testicle will come down naturally before the baby is 3 months old. If not, the baby will usually need an operation to bring the testicle down. This should be done between 6 and 12 months of age (Seminars in Pediatric Surgery 2010;19:215-24).

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 embarrassed, because all doctors know this is a problem that needs attention. There are at least several issues that you will need to discuss with the urologist.

Testicular cancer. An undescended testicle is slightly more likely to develop cancer than a normal testicle. The risk is roughly 1 in 2000. (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, but your urologist will advise you.

Fertility. 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.

Torsion. 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.

Testicular implants. 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).

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Tuesday, January 3rd 2017


Dr Phil Hammond discusses plums, peas and varicocele in his Expert guide to scrotal lumps video.

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Comments on this article

Posted by Ravi on 22/04/2017 at 07:05

I have an an undescended testicle , I am very afraid that it might develop cancer and cause other problem what should I do ?

Posted by Joed on 15/02/2017 at 09:35

hi, having one testicle on the left part have been occurred when I was 9 or 10 years old. It's almost 11 years already and still, one of my testicles is living in my abdomen/disappearing or what we called ' undescended testicle ' . I don't have problem with my sex life. I just feel embarased for myself where I can't open it even to my parents. I never went yet in hospitals to talk to urologists about it. Do I really need a surgery if I don't feel anything bad about it? Help me, I feel embarrassed, really. Thank you.

Posted by rj on 26/05/2016 at 04:14

hi... am 28 yrs old born with single testicle... i had enquired doctors n scanned for any hidden testicle inside.. but nothing was found.. and they said everything is normal... But i had a guilty feeling about sexual life and fertility as am about to marry now....but nw thanx for ur great article... i hav a great relief from now....thanx a lot...

Posted by Majola on 09/10/2015 at 10:51

I'm born with one testicle in the right place. An I'm a married man for the period of 12year's I've been trying to have a babe but nothing what sow ever, not even a miscarriage was. I'm not having any problem in my sex life. pls help me tackle this promblem.

Posted by Optional on 01/07/2015 at 10:50

At the age of around 9 a guy kicked on my testicle,because of that one testicle went up,I could feel the presence of that testicle,at that age I was very worried that how would I tell my parents about it and how I share it with a doctor,so I choose to let it be there.Till now I dun feel any problem with the Ejaculation or the erection of penis,as I am a strong Guy,but the only thing which bothers me alot is this that i dun feel the presence of that testicle anymore and i did research about it,and on most of the forum i come to know that the undescended testicle will develop cancer,Now I am 22 years old and till now I have not take suggestion from any doctor as I am shy and I feel embarrassed,and i feel scared of surgery as i doubt the doctors might not defect the functioning testicle and it might not make me infertile,kindly suggest me what should I do ?If a do a surgery is there is still a chance that the undescended testicle could be fixed on it's correct position? I am worried about it.kindly help me in this,thanks

Posted by Optional on 20/12/2014 at 02:06

I am 62 years old man and have always had testicals that stay close up against my body and do not hang. I also suffer with bloody ejaculation at times. I was told that there is a flap near my prostrate that malfunctions and should just live with it? Help

Posted by Optional on 18/02/2014 at 09:58

i am 50 i have an undesent right testis my left one is normal i have 19 millions count of sperm,my consultant has advised me to removec it, i am anxious.pls help

Posted by Anonymous on 28/07/2013 at 06:57

Thank you i was always worried about one of my testicles temoorarily dissapeearing when im cold and you helped me understand im glad inwas able to fix it and not make it a bug thing with my parents and doctors again thank you a lot.


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