Retractile testicles

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.
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4 thoughts on “Retractile testicles

  1. Hi, I’m 16 years old and when I masturbate my left testicle rises up to a point where it is almost level with the base of my penis, is the normal? I’m extremely worried, help!

  2. My son, now 2 years and 9 months old has a small scrotum and his testes are hardly ever there. I noticed this during nappy change, however sometimes they also appear to be present. For example if he goes into the squat position or in a warm bath.

    But I worry that they are up in the abdomen much more often than in the scrotal sack, and his scrotum looks quite underdeveloped and small, whereas his testicles which are palpable are not small and feel a good size.

    I thought he must be normal, and has retractile testicles, but then I started worrying that his fertility might be affected since they are retraced for such long periods of time (most of the time). We have now booked an appointment with our GP, and no one seems to have noticed any anomalies in his previous checkups, but then again we all know how things like this can easily be missed.

    What are your thoughts, and does my description sound like retractile testicles? What cut off age is fertility compromised if these issues are not corrected?

    There seem to be a million studies, opinions and confusing information online, which is why most Doctors recommend not going overboard with trying to diagnose anything without a professional I guess. I am just worried that I have let my son down by not noticing and getting this checked earlies.

    1. Hi Adam, Second time writing this reply as my browser ate the first one!

      First you haven’t let your son down – he’s had multiple checkups with health visitors et al and if they haven’t spotted anything, why should you?

      From what you write it sounds a lot like retractile testicles. If so, the good news is that even though they spend time up in the abdomen studies say the testicles aren’t harmed by this, and don’t develop the abnormalities of undescended testicles. Are you able to “milk” the testicles into the scrotum (see https://undescendedtesticles.wordpress.com/treatments/#palpable-testes for instructions)? And if you hold them there until the cremaster muscle is worn out, do they stay?

      Alternatively he could be developing acquired undescended testicle(s) where as he grows they start to disappear inside. This is what I had and you can read more here: https://undescendedtesticles.wordpress.com/my-story-orchidopexy/. If he does, they will monitor it or perform surgery now. There’s still good news, as acquired UTs show fewer (maybe 1/3) abnormalities than UTs you’re born with.

      Please let me know how your son gets on, either here or via email if you’re more comfortable. And Good luck!

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