Where Are My Son’s Testicles?

By Anthony Tracey, M.D.


Most male infants are usually born with both testicles resting comfortably in their scrotum.

The testicles normally make their way into the scrotum at around 32-36 weeks gestation.

In about 3% of full-term newborn males, one or both their testicles may not have fully dropped into scrotum. This is also true in about one-third of premature boys.

The good news is that the majority of these testicles will spontaneously descend on their own in the next three to six months. After 6 months of age, less than 1% of baby boys will still have this issue. This can affect one or both of your son’s testicles.

Why is this a problem you may ask?

Your son’s testicles should be in his scrotum for several important reasons. The first reason most people think of is future fertility. We know through many scientific studies that testicles develop best when they are in the scrotum due to the lower temperature and the special environment created there. The maximum fertility benefit of the scrotum involves getting the testicles down between the ages of 6 and 18 months of age.

The second reason parents are concerned about the location of their son’s testicle is the risk of testicle cancer.

There is a well-documented relationship between testicle cancer and undescended testicles. More contemporary studies still show an increased risk of developing testicle cancer in an undescended testis or a previously undescended testicle, however the risk is most likely not as high as we once thought.

Making sure the testicles are down in the scrotum and able to be examined regularly is essential.

Anyone with testicles is at risk of testicle cancer and finding it early is the key to successful treatment.

Bi-monthly self-exams when your son goes through puberty is a great idea.

Two other reasons why parents should be concerned about undescended testicles are hernias and testicle torsion. Many undescended testicles also have inguinal hernias associated with them. At the time the surgery, these hernias are also fixed by the pediatric urologist to prevent future problems. Undescended testicles can also twist more easily when they are not secured in the scrotum. A twisted testicle is a serious problem and a medical emergency.

Ask Your Doctor

When should you ask your doctor about your son’s testicles?

As soon as he is born, your pediatrician should examine him and make sure both testicles are down, if they are not or there is a question, they should be seen by a pediatric urologist.

Some testicles are not really undescended but move back and forth between the scrotum and the groin, we call this a retractile testis.

Who should do your son’s surgery if needed? The American Academy of Pediatrics (AAP) recommends that fellowship-trained pediatric urologists perform these procedures given their expertise and training in this area. The success rate of putting the testicle in the scrotum (called an “orchiopexy”) is above to 95%. So please come and see us!

Urologist Anthony Tracey is an assistant professor in the department of urology at SUNY Upstate Medical University. He is board-certified in urology and board sub-certified in pediatric urology. He is a fellow of the American Academy of Pediatrics, the Society of Pediatric Urology and the Society of Fetal Urology.