An undescended testicle, or cryptorchidism, is a common condition in newborn boys where one or both testicles have not moved into the scrotum. It occurs in about 1-3% of full-term male infants. In many cases, the testicles descend on their own within the first few months of life. When a testicle remains undescended, diagnostic imaging becomes a standard part of the medical evaluation to determine its location and condition.
Purpose of an Ultrasound for an Undescended Testicle
The main reason for an ultrasound is to locate a testicle that a doctor cannot feel during a physical exam, a situation referred to as a non-palpable testis. The imaging test can often find the testicle positioned along the normal path of descent, most frequently within the inguinal canal, which is a passage in the lower abdominal wall.
Beyond just finding the testicle, an ultrasound serves other purposes. The procedure allows a specialist to measure the size of the undescended testicle and compare it to the one in the scrotum. These measurements help in assessing its development. The sonographer will also evaluate the tissue’s appearance, looking for a normal, uniform, and oval structure.
This detailed look at the testicle’s structure and size helps determine if it is healthy or potentially atrophic, meaning it is small and underdeveloped. The ultrasound can also assess blood flow to the testicle, which provides information on its viability.
The Ultrasound Examination Process
The ultrasound examination is a straightforward and painless procedure. A healthcare professional, usually a sonographer, will apply a small amount of warm, water-based gel to the skin of the lower abdomen and groin area. This gel helps the sound waves travel from the ultrasound machine’s probe, called a transducer, into the body.
The sonographer then gently presses the handheld transducer against the skin and moves it over the area where the testicle is suspected to be. The process is non-invasive and does not use any ionizing radiation. For parents, keeping their child calm can be helpful; bringing a favorite toy or book can provide a useful distraction during the short examination.
Understanding the Ultrasound Findings
After the examination, a radiologist will interpret the images, and several outcomes are possible. A common finding is the successful localization of the testicle. Often, it is identified as a healthy, well-formed structure located within the inguinal canal.
Another possibility is that the ultrasound identifies an atrophic, or underdeveloped, testicle. This means the testicle is significantly smaller than expected and may have an abnormal texture. This finding suggests the testicle may not be viable or fully functional.
It is also possible that the ultrasound does not visualize a testicle at all. This result does not definitively mean a testicle is absent. Ultrasound technology has limitations and may not be able to detect a testicle located higher in the abdomen, outside the range of the sound waves. An intra-abdominal testicle is often beyond the reach of a standard ultrasound, so a negative scan simply means the testicle was not found in the areas that could be assessed.
Treatment Pathways Following the Ultrasound
If a viable testicle is located in the inguinal canal or another location outside the scrotum, the standard treatment is a surgical procedure. This surgery, known as an orchiopexy, involves carefully moving the testicle into its proper position in the scrotum and securing it. This is typically recommended between six and twelve months of age.
If the ultrasound does not locate the testicle, further investigation is needed. The next step is often a diagnostic laparoscopy. This is a minimally invasive surgical procedure where a surgeon inserts a small camera through a tiny incision in the abdomen to search for the missing testicle. This approach allows for a direct view of the abdominal cavity to confirm if a testicle is present, absent, or atrophic.
Treating an undescended testicle is important for a child’s long-term health. Properly positioning the testicle in the scrotum helps support future fertility potential. It also allows for easier monitoring and reduces the risk of developing other health issues later in life, such as testicular cancer.