Dr. Raghul M
M.Ch (Gold Medalist) • Pediatric Surgeon & Pediatric Urologist
During the first seven months of fetal development inside the womb, a baby boy's testicles are located high in the posterior abdomen near the kidneys. Under the influence of fetal hormones and anatomical guides called the gubernaculum, the testicles embark on an extraordinary journey, descending through the inguinal canal into the scrotum shortly before birth.
In approximately three to four percent of full-term boys—and up to thirty percent of premature infants—this migration is incomplete, leaving one or both testicles stranded in the abdomen or groin canal at birth. This condition is medically termed cryptorchidism.
Dr. Raghul M
@dr_raghul_maniam • Clinical Reel
Undescended Testis (Cryptorchidism) in Newborns and Infants: Diagnosis, Timeline & Gentle Surgical Fix
Click to watch reel
In the first three to six months following birth, a newborn experiences a natural surge in testosterone and gonadotropins (often called 'mini-puberty'). In many infants, this hormonal surge successfully coaxes a high testicle to complete its descent into the scrotum naturally.
However, if the testicle has not settled into the scrotum by six months of age, spontaneous descent will not occur. Leaving the testicle inside the warmer core of the body past one year of age leads to progressive heat-induced damage of spermatogonial stem cells, increasing the risk of future adult infertility and testicular tumors.
Corrective surgical placement (orchidopexy) is recommended between nine and twelve months of age. For palpable testes in the groin, a tiny cosmetic skin-crease incision allows the surgeon to mobilize the spermatic vessels and secure the testicle comfortably in a scrotal dartos pouch.
For non-palpable testes hidden inside the abdomen, miniature diagnostic laparoscopy with two-millimeter instruments locates the testicle and brings it down with microscopic precision. The surgery takes less than an hour, is performed under general anesthesia with local nerve blocks, and allows the baby to return home the same day feeding and crawling happily.
Further clinical guidance, parent guides, and surgical monographs curated by Dr. Raghul M.
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