Knowing if your son has a retractile testicle, rather than an undescended testicle, can save him (and you!) from the trauma of surgery.
What is a retractile testicle?
Before birth your son’s testicles descended down a tunnel and into the scrotum. A retractile testicle is one which descended properly, but the muscle attached to the testicle is too sensitive and pulls the testicle up and down this tunnel like a yo-yo on a string.
Retractile testicles are commonly described as testicle that do not always rest down in his scrotum, but often will be seen there when he is in the bath or asleep. A retractile testicle is sometimes seen outside of the scrotum due to an active cremasteric reflex. The cremasteric reflex is elicited by lightly stroking the inner part of the thigh
Whether or not the testicle spends most of the time in the scrotum, so long as it can be brought into the normal position no surgery is necessary. A retractile testicle doesn’t need surgery.
Let me repeat: regardless of what some surgeons will say, your infant son doesn’t need an operation if he has a retractile testicle.
This video helps to explain:
Our consultant isn’t sure if it’s retractile and wants to operate?
Sometimes it may be difficult to tell the difference between a retractile testicle and an undescended testicle (one that never made the full trip into the scrotum during development). There are significant differences between the two conditions. Undescended testicles have a higher risk of problems making hormones or sperm and development of cancer. Retractile testes don’t have a higher risk of these problems.
When I had my surgery they marked one testicle as definitely undescended and the other with a question mark. In the operating theatre, once I was asleep, they found it to be retractile (under anaesthetic everything relaxes, so a retractile testicle descends) so thankfully they only had to operate on one testicle.
So, learn to identify if your son has a retractile testicle, and make sure the doctor doesn’t automatically assume it’s undescended.
My son had a retractile testicle. Why does he now need surgery?
OK, I know I said above that surgery isn’t needed for retractile testicles. However, sometimes the pipes and muscle attached to the testicle don’t grow longer as your son grows taller, and the testicle gets lodged inside his body. This is known as a reascended testicle and needs surgery to bring it down into the scrotum. Studies are vague about how often this happens: one says for 1-4% of retractile testicles, another up to 32% of retractile testicles.
These statistics are the reason why a trigger-happy surgeon may see a retractile testicle in your baby boy and decide to operate anyway – because if 32% need an orchiopexy anyhow, why not do it now (and hand over the money regardless). Don’t let him!
Instead, schedule periodic examinations as your son grows to make sure that the testicle can be brought into the normal position.
What happened to my retractile testicle?
Mine descended normally when I reached puberty. It is less well attached in the scrotum than other testicles, but causes no problems.
Tips for managing a retractile testis
- Do not just feel from the bottom of the scrotum to see if the testicle is present, this will induce the cremasteric reflex and make it difficult for you to find the testicle.
- Do examine for the testicles in the scrotum while your child is asleep or relaxing in the bath, often the testicles will be found in the scrotum during these times very easily.
- Do have your son squat into a “baseball catcher’s position” to exam him, this relaxes the cremaster muscle and allows the testicles to relax into the scrotum well.