Undescended Testes / Testicular Torsion

Undescended testes (cryptorchidism) and testicular torsion are two distinct but critical pediatric conditions affecting the male reproductive system. While undescended testes refer to a testicle that hasn’t moved into its proper position in the scrotum by birth, testicular torsion is a sudden and painful twisting of the spermatic cord, which can cut off blood flow to the testicle and constitutes a surgical emergency.

Undescended Testes (Cryptorchidism)

Undescended testes are one of the most common congenital conditions in male infants. In most cases, the testicle will descend on its own within the first few months of life. However, if the testicle does not descend by six months, surgery (orchiopexy) is typically recommended to reduce the risk of fertility issues and testicular cancer later in life.

Undescended testes may be located in the abdomen, groin, or just outside the scrotum. The condition may affect one or both sides. Diagnosis is made through physical exam and sometimes confirmed with imaging if the testicle is not palpable.

Testicular Torsion

Testicular torsion occurs when the spermatic cord twists, cutting off the blood supply to the testicle. It typically affects adolescent boys but can occur at any age, including infancy. Symptoms include sudden, severe scrotal pain, swelling, nausea, and abdominal discomfort.

This is a urologic emergency—if not treated within 6 hours, there is a significant risk of permanent testicular damage or loss. Diagnosis is based on physical exam and confirmed by ultrasound. Surgery is required to untwist the cord and restore blood flow, and often the opposite testicle is secured at the same time to prevent future torsion.

Treatment and Follow-Up

Undescended testes are treated with orchiopexy, a minimally invasive procedure performed as an outpatient surgery. Early intervention, ideally before 12–18 months of age, improves outcomes for fertility and cancer prevention.

Testicular torsion requires immediate surgical intervention. The goal is to restore blood flow and preserve testicular function. Follow-up may involve hormone assessments, fertility evaluation in the future, and reassurance for patients and families about long-term health.

Divisions Involved in Your Care

Procedures We Use

Frequently Asked Questions

Undescended testes is a congenital condition where one or both testicles have not moved into the scrotum. Testicular torsion is a sudden twisting of the spermatic cord that cuts off blood supply and requires emergency surgery.

If the testicle hasn’t descended by 6 months of age, surgery is typically recommended before 12–18 months to protect future fertility and reduce cancer risk.

It is a medical emergency. If blood flow isn’t restored within a few hours, the testicle can be permanently damaged or lost.

Yes. Untreated undescended testes and delayed treatment of torsion may impact sperm production and hormone levels later in life.

Doctors rely on physical exam findings and urgent ultrasound imaging to confirm torsion and proceed with immediate surgery.