Undescended Testicle

Written & reviewed by the BestDoctors.sg editorial team · Last updated 2 Sep 2026 · General information, not medical advice

Finding that a baby boy’s scrotum feels empty on one or both sides can be worrying, but an undescended testicle is a common and treatable condition. This guide explains what it is, why it matters for long-term health, how it is assessed, and what treatment usually involves in Singapore. It is general information and not a substitute for a doctor’s assessment.

What it is

Before birth, the testicles form inside the abdomen and gradually move down into the scrotum. An undescended testicle is when one or both have not completed this journey by the time a baby is born. It is one of the most common conditions seen in baby boys. In many cases the testicle descends on its own during the early months of life. When it does not, treatment is recommended, because a testicle sitting outside the scrotum matters for long-term health.

How it is noticed

An undescended testicle is usually found when a doctor cannot feel a testicle in the scrotum, so the scrotum looks or feels empty or under-filled on one or both sides. This is most often picked up at the newborn examination or at routine baby and childhood health checks. Parents sometimes notice it themselves during nappy changes or bathing. It is not painful and the baby is otherwise well.

Retractile versus truly undescended

It is worth knowing the difference between a retractile and a truly undescended testicle. A retractile testicle sits in the scrotum but can pull up temporarily — for example when a child is cold or ticklish — and then returns on its own or can be gently guided back. This is usually normal and does not need surgery, though a doctor may keep an eye on it. A truly undescended testicle stays up and cannot be brought down into the scrotum. A doctor’s examination helps tell the two apart.

Why it matters

Correcting an undescended testicle is not just cosmetic. Over the long term, an undescended testicle is linked with lower fertility later in life and with a higher risk of testicular cancer in adulthood. A testicle that is not properly anchored in the scrotum can also be more prone to twisting. Bringing the testicle into the scrotum and staying “testes-aware” — getting used to how the testicles feel so changes are noticed — helps reduce and manage these risks.

Causes and who is at risk

The exact cause is often unknown. It is more common in babies who are born prematurely or with a low birth weight, because the testicles descend late in pregnancy and there may not have been time for the process to finish. A family history can play a part in some cases. In most boys, though, there is no single identifiable reason and nothing the parents did or did not do caused it.

How it is assessed

Assessment is mainly by a careful physical examination. A doctor feels the scrotum and groin, in a warm and relaxed setting, to work out whether the testicle can be felt and whether it can be guided into place. Imaging scans are not usually needed and often do not add useful information. If a testicle cannot be felt at all, a paediatric or urological surgeon may assess further, sometimes with a look inside using keyhole techniques, to locate the testicle and plan treatment.

Treatment

If a testicle has not descended on its own by the recommended time, the treatment is an operation to bring it down and secure it in the scrotum. This procedure is called an orchidopexy. A surgeon frees the testicle from where it is sitting, moves it into the scrotum and fixes it in position. It is generally done in early childhood, as a planned day operation, and is usually straightforward. Doing it at the recommended age gives the testicle the best chance to develop and function well. Your surgeon will explain what the operation involves, the aftercare and any risks in your child’s specific situation.

Long-term health

The outlook after treatment is generally good, and fertility is usually good too, especially when the testicle is brought down early. Because there is a slightly higher lifelong risk of testicular cancer, it is important that boys learn to check their own testicles regularly once they reach adolescence and adulthood, and are aware of any changes in size, shape, firmness or the appearance of a lump. Being testes-aware means changes are more likely to be picked up and checked promptly. A doctor can show the right technique.

When to see a doctor

See a paediatrician if your baby’s scrotum feels empty on one or both sides, or if a testicle that was previously in place seems to have moved up and stays up. It is also worth a review if you are unsure whether a testicle is retractile or truly undescended. Seek urgent care — go to A&E or call 995 — for a sudden painful, swollen testicle or groin at any age, as this can signal a twisted testicle (torsion), which needs treatment quickly. In later life, any new testicular lump should always be checked by a doctor.

Common questions

Will an undescended testicle come down on its own?

In many babies it does descend by itself in the early months. If it has not by the recommended time, it is unlikely to descend later, and treatment is advised.

Does an undescended testicle cause pain?

No, it is usually painless and the baby is otherwise well. Sudden severe pain and swelling is a different, urgent problem and needs emergency care.

Can my son still father children later?

Fertility is usually good, particularly when the testicle is brought into the scrotum early. Having both testicles corrected in good time gives the best chance.

Is the operation major surgery?

Orchidopexy is generally a straightforward, planned day operation done in early childhood. Your surgeon will explain the details and aftercare for your child.

What if the testicle cannot be felt at all?

A paediatric or urological surgeon may assess further, sometimes with keyhole techniques, to find the testicle and plan the right treatment.

Related guides

• Testicular torsion
• Testicular lump & pain
• Hydrocele
• Testicular cancer
• Low Testosterone (Male Hypogonadism) in Singapore

Sources

• KK Women’s and Children’s Hospital
• HealthHub
• NHS
• Urological Association