Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be talking to you about

undescended testes. And if you want to follow along with written notes on this topic, you can follow

along at Zerodefinals.com slash Undesended Testes or in the renal and urology section of the

Zero to Finals pediatrics book.

So let's get straight into it.

The testes develop in the abdomen and then gradually migrate down through the inguinal

canal and into the scrotum.

They have normally reached the scrotum prior to birth.

In about 5% of boys the testes have not made it out of the

abdomen by birth. At this point, they're called undescended testes. This is also known as

crypto orchidism. The testes may be palpable in the inguinal canal, in the ingrenal region,

which is not technically classed as

undescended, although they've not fully descended at that point. The longer the testes take to

descend, the less likely it is that it will happen spontaneously. Undescended testes in older children

or after puberty hold a higher risk of testicular torsion, infertility and

testicular cancer. There's a few risk factors to be aware of. Family history of undescended

testes, low birth weight, small for gestational age, prematurity and maternal smoking during pregnancy.

Let's talk about the management.

Watchful waiting is appropriate in newborns.

In most cases, the testes will descend in the first three to six months.

If they've not descended by six months, they should be seen by a pediatric urologist.

Orchidopexy, which is a surgical correction of undescended testes, should be carried out between 6 and 12 months if they've not descended by that point. Finally let's talk about retractile testicles.

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