Can you see or feel only one testicle in your child’s scrotum? One possible reason is an undescended testicle. This guide to an undescended testicle in children explains what the finding can mean, what a paediatrician checks, and when your child may need to see a specialist.
Bring it up with your child’s paediatrician, even if your child feels well. A physical examination is usually the first step. Tell the doctor if the testicle was previously seen or felt in the scrotum.
What is an undescended testicle?
Before birth, the testicles develop in the abdomen and normally move down through the groin into the scrotum, the pouch of skin below the penis. If one or both testicles do not reach the scrotum, the condition is called cryptorchidism. The testicle may be in the groin or higher up.
This is more common in babies born prematurely. For more background, read our guide to why the testicles normally sit outside the body.
Why might only one testicle be visible?
One testicle may not have descended
One side of the scrotum may look less full. The paediatrician may be able to feel the testicle in the groin, or it may be difficult to feel during the examination. The appearance alone cannot tell you where it is.
A testicle may move up temporarily
A retractile testicle can move upwards when a muscle reflex is triggered, such as when a child is cold. During an examination, the doctor can gently bring it into the scrotum, where it stays at least briefly. A paediatrician may recheck its position at later visits because some retractile testicles later move up and stay there.
A previously descended testicle may have moved upwards
A testicle that used to sit in the scrotum can move up and no longer stay there. This is called an ascending testicle. If both testicles are in the scrotum and one simply hangs lower, read why the two testicles may sit at different heights.
You may first notice that one side of the scrotum looks less full while changing a nappy or helping your child get dressed. If that side sometimes looks fuller and sometimes looks empty, mention that pattern to your paediatrician. You can describe what you noticed without trying to find or move the testicle yourself.
Watch the Nisarga Diagnostics Reel
The Reel explains why one side of the scrotum can appear empty and why it is worth bringing up at a paediatric visit. Share it with another parent who may have the same question.
Watch the original Reel on Instagram.
What does the paediatrician check?
The doctor checks both sides of the scrotum and may feel along the groin. They may ask whether your child was born prematurely, whether both testicles were felt during earlier checks, and whether the position seems to change. These details help distinguish a retractile testicle from an undescended or ascending one.
When might my child need a specialist assessment?
If a baby’s testicle has not descended by six months of age, adjusted for prematurity, guidelines recommend referral to a paediatric urologist or paediatric surgeon. If a testicle is first found outside the scrotum after six months, arrange a paediatric assessment promptly so your doctor can advise on referral.
Early treatment aims to protect future fertility. An undescended testicle also carries a higher lifetime risk of testicular cancer, and your child’s specialist can explain what follow-up is appropriate.
What happens at a specialist visit?
The specialist will review your child’s earlier examinations and check the position again. If they can feel the testicle in the groin, that finding helps them plan treatment. If they cannot feel it, they may recommend an examination under anaesthesia and, in some cases, keyhole surgery to look for it and treat it if possible.
If the specialist confirms a retractile testicle, they will usually recommend regular checks as your child grows. Ask how often to return and what to do if the testicle seems to stay out of the scrotum.
Is an ultrasound needed?
An ultrasound is generally unnecessary before referral for a suspected undescended testicle. Your child’s doctor will advise if a test is needed for a specific reason.
What to share at your child’s appointment
Tell your paediatrician when you first noticed the difference, whether one side sometimes looks fuller, and whether an earlier check documented both testicles in the scrotum. Bring your child’s newborn or well-child records if you have them.
Ask whether the testicle can be felt, whether it stays in the scrotum during the examination, and when your child should have a follow-up or specialist assessment.
Frequently asked questions
Can an undescended testicle come down on its own?
Some descend during the first few months of life. If the testicle is still undescended at six months of age, adjusted for prematurity, a specialist assessment is recommended because descent after that point is unlikely.
Can both testicles be undescended?
Yes. One or both can be affected. If a newborn has neither testicle felt on examination, the medical team should arrange prompt specialist evaluation.
Does an undescended testicle usually hurt?
Many children have no pain. If your child develops sudden, severe pain in a testicle or the scrotum, go to an emergency department immediately. Testicular torsion is one possible cause and needs urgent treatment.
Is one side hanging lower the same thing as an undescended testicle?
If both testicles are in the scrotum, one can sit lower than the other. An undescended testicle is outside the scrotum. If you are unsure whether both are in place, ask your child’s paediatrician to check.
Can an older child develop this even after a normal newborn check?
Yes. A testicle that was previously in the scrotum can move upwards as a child grows. If you notice a change, arrange an assessment with your paediatrician.
How is a persistently undescended testicle treated?
A specialist may recommend orchiopexy, an operation that moves the testicle into the scrotum and secures it in place. For infants with a persistently undescended testicle, guidelines recommend treatment ideally by 12 months and by 18 months at the latest. The specialist will discuss timing and follow-up with you.
What does “non-palpable” mean in my child’s notes?
It means the doctor could not feel the testicle during the examination. It may be higher in the groin or abdomen, or it may be absent. A specialist can advise how to establish where it is and what care is needed.
Will my child need follow-up after surgery?
Yes. The specialist checks healing and whether the testicle remains in the scrotum, then explains what to watch for as your child grows. Ask when to return for the next check.
Questions for Nisarga Diagnostics
Start with your child’s paediatrician if you can see or feel only one testicle in the scrotum. If your doctor has requested an investigation, you can contact Nisarga Diagnostics in Sanjaynagar, Bengaluru with the referral details.
Medical references
Founder of Nisarga Diagnostics, is a renowned fetal ultrasound specialist with over 20 years of expertise. An alumnus of Government Medical Colleges in Mysore and Bangalore, he also holds a D.N.B. from the National Board of Examinations, Delhi, and certification from the Fetal Medicine Foundation, London. A former Professor and HOD, he has trained countless PG students and junior radiologists, shaping the future of fetal imaging in India.