Undescended Testicle

Archived Q&A and Reviews

Baby boy has an undescended Testicle

May 2006

My 10-month-old son has an undescended testicle, and our pediatrician has referred us to Children's Hospital for a consult and then for surgery when he's 1. My questions:

1) Has anyone else's son had this problem and this surgery? I know it's not supposed to be a big deal, and it's not an uncommon problem, etc., but I'm worried!

2) Has anyone had experience with Dr. James Betts? (I know this is more of a Recommendations question, but while I'm asking in general about this issue...) Our ped said she'd heard good things about him - I can't find anything on the BPN website, though.

Thanks so much -
Mom of the one-ball wonder

My nephew had the same problem. He had the surgery done in Tucson AZ where he lives and there were no lasting problems or issues. He had a bandage on his belly and drank milk and watched TV quite a bit the first day after the surgery. But it was back to business as usual within a couple days. Try not to worry. This is a very routine procedure that is commonly done these days to ensure that a child develops normally and maintains full fertility. I have no knowledge of Dr. Betts, but Children's Hospital has a very good reputation -Katie
You're right, it is common, but it's important to get it treated. I have to warn you, this can possibly cause fertility probllems for your son down the road.... the doctors will tell you that's not true, but it can happen. It's entirely possilbe that his undescended testitcle was caused by bacteria. There is a wonderful doctor in NY called Dr. Toth who specializes in this sort of thing. Good lcuk! -- Dealing with it, many years later
My son had his undescended testes janked down and secured into place at Children's. He was big and healthy so we did it at 3 months while I was on maternity leave. We went in at 7 and were on our way home by 11 with him breastfeeding. He was slightly fussy the next 24 hours, relieved by Tylenol. He has an almost invisible 2 inch scar along a normal skin crease. He is 6 now and somewhat disappointed he doesn't have a dramatic scar, since we've told him about his surgery. I know the pediatric surgeons personally and all are excellant. Dr. Betts is not warm and fuzzy, but it's what happens when your child is asleep in the OR that matters.

Funny story- at first they thought he didn't really have one testes but they had to explore anyway as a shriveled one is a risk for cancer...before the ultrasound found it high up the surgeon gave me a little talk about how if he grows up with only one, he won't even give it a second thought or feel self- conscious. As you might guess, this was someone who had never raised or been a teenage boy!
Two balls now on the proper court

Hello, I wanted to recommend a wonderful urologist who worked with my child for another condition. He's amazing and was so warm and caring toward my son. Despite the awkwardness of the situation, my kid loved him. His name is Dr. Piser and he is located in Berkeley. His number is 848-1727. He has a good reputation. In fact, my pediatrician and obstetrician have heard good things about him. Good luck! Anon
My son just had surgery to correct an undescended testicle. He is 11 years old. I wish he had the surgery years ago but alas he didn't. Nonetheless, the surgery went well. It was at Children's Hospital. His doctor was Dr. Lee who seems to be an excellent doctor. My son felt pretty sore and on pain meds for 2 days. After that he used lower and lower doses of meds--first using codine and then switching to motrin--for about one to two weeks. It's been about a month and he's ready to resume normal activities.

The staff at Children's is very supportive to the kids and parents. Good luck mom

I can't speak to your message about your sons medical needs, but I'd like to ease your mind about Dr. Betts.

Last year, my then 2.5 year old was diagnosed with a double ingunal (sp?) hernia. My ped. recommended Dr. Betts because in her words, ''he is a brilliant surgeon. The one I would choose to operate on my own kids.'' She also mentioned his brisk and sometimes cold bedside manner. With me, he was a little short, but with my son, he was wonderful! Besides, I'd rather have the confident not so chatty but brilliant surgeon rather than the other way around. You didn't ask about Children's Hospital but I'll tell you that they are great too. Very practiced in the process of surgery, they make the scary experience seem less so. And one more piece of anecdotal information... I had a serious relationship with a guy in college with an untreated undecended testicle. There was always a question in his mind about the ease of creating children. Even with one up and one down, he's got two very beautiful children now that were easy to concieve! Best, Dana

My nephew had this and he had surgery and everything went just fine. I understand that it is fairly routine and nothing to worry about. Obviously, you always worry when it's your child, but my nephew is now 11 years old and has had absolutely no difficulties. I am not certain about the doctor but trust your instincts. When you meet him if you don't feel comfortable, wait and find someone you do. There is a lot of trust that needs to be there and you'll know in your heart if he is the right guy for the job. anon
My now 3 yr old had an undescended testicle ( and a hernia ) we ended up doing the surgery last year.We went to childrens and dr betts did the procedure. We had the best possible experience we could hope for! Everyone there was amazing ,friendly and helpful. Our anathesia guy was so fabulous ,he spent time talking to us about options . dr betts is a pro. he is very to the point , some may say his bedside manner is a bit short, or cold, we were fine with that because truly he loves what he does taking care of his patients.My little one even drew pictures for some of the staff and we brought them to them on our post op visit . anyway I could go on for days about our wonderful experience so if you want ,email me. It can be scary having your little one put under I know I've been there.
My son had an undescended testicle until he was 6 or 7, and his father's testicles still occasionally ''ascend'' if physically pushed. We never thought surgery was necessary for either anonymous
I was the original poster of an archived question about an orchiopexy and circ revision with Dr. Betts; I thought I'd write with the results of our experience. First of all, we are totally confident that Dr. Betts is the most qualified surgeon we could have found for this procedure; his reputation is stellar and he really knows what he is doing. In addition to having a ton of experience and working at a really great hospital, he is a true perfectionist and will not do anything unless it's done JUST right. The disadvantage of this is that you may be inconvenienced in terms of schedule . . . for example, Dr. Betts is so busy that you may have a hard time getting a good time or date for your surgery; you may have to wait while he spends extra time with a prior patient; you may have to reschedule if your son has any health problems (like a cold or rash) that he sees as potential complications. And like most surgeons, he has a slightly brusque bedside manner. But behind all this you've got a really top-notch, competent, and caring doctor. Similarly, Children's Hospital can be a bit impersonal at times -- it is definitely a big hospital and not an intimate clinic -- but they really know how to deal with kids and the quality of care is excellent. As for the procedure itself, everything went VERY smoothly and much easier than anticipated, Our son (18 months at the time) played happily in the waiting room; once in the office, the nurses gave him an oral sedative and he was instantly relaxed. He had no anxiety when the anesthesiologists took him away. He did have a hard time waking up, thrashing and crying for a long time in the recovery room, but I got to hold and nurse him, and once he was alert, he was totally fine and only needed one dose of regular Tylenol to get through it. He was running around playing the next day. The scars are scarcely visible now; the testicle ended up in exactly the right place, and the circ is perfect too. Our son has not been scared of doctors since, though he shows a lot of interest in a book we got him about the hospital. Of course you can't shut off your anxieties about something like this, but if there is anything else I can tell you to ease your mind, please email me
Our son (now 32 months) had laparoscopic surgery to explore whether he had a second testicle that was undescended since an ultrasound did not reveal anything. Patte Bishop was our surgeon. As it turned out, the left testis was absent. Our experience with Children's was great. The staff were all very helpful. The anesthesia is what most people seem to be worried about and that all went fine and on schedule. We were anxious and nervous but he did not know any better being 16 months old. We did have to get up very early and arranged for our older child to be with my sister's family over night and scheduled help for the afternoon which we did not need since we were home by 11:30am. Our son slept peacefully after the surgery and did not seem to have any pain or discomfort at all (we did give him Tylenol regularly for the first couple of days). Dr. Bishop was really wonderful and I recommend her highly if you have any reservations about Dr. Betts. Best of luck to you. anon
Our boy was two when we took him for surgery on an undescended testicle. A doctor at UCSF performed the surgery and it went quite well. Because we had waited until he had begun to acquire language and was a bit more aware of the surgery, I scheduled a ''child life'' session for us one or two days before the surgery. I know they have child life specialists at Children's Hospital in Oakland as well, and I think it's really helpful. Primarily it's important for parents to know what to expect and to prepare psychologically for the event. It is imperitive that parents present a calm, reassuring demeanor to the infant/child, and believe me, it's not easy to watch your little one go through this. I don't remember exact details, but your infant must go without anything in his stomach for many hours before the surgery; the time of day for the surgery is important to consider with this in mind. We, for example, chose the first surgery of the day. It is also essential to be there at the instant your child wakes up from anesthesia. In the post-op room, we witnessed several children who woke up screaming and/or obviously quite upset, and we felt lucky that our child eased more slowly into consciousness. I was there instantly, scooping him up in my arms in his favorite blankie and nursing him. He was fine and is now a happy, healthy almost 5 year old. If you have questions about the doctor, ask directly about his/her experience with this specific surgery (e.g. successes vs. problems and what kinds of problems). When I asked our doctor this, he said he had done thousands of these surgeries and had only a handful of very correctable problems. Good luck! Richele

Surgery for 1-year-old - undescended testicles

May 2005

My one-year-old son is being scheduled for surgery in June to correct bilateral undescended testicles and foreskin adhesions (caused by a ''conservative'' circumcision that now needs to be trimmed - who knew that could happen?). I know that he is probably too young to remember his hospital experience, but he is also too young for me to explain it to him on any level. I wonder if there is a possibility that genital surgery at this age could affect him psychologically; I also had urologic surgery as a child and it definitely gave me some weird ideas about my body and about the medical establishment. And then there's the anesthesia . . . it's hard to think about my baby being unconscious! Should I just stop worrying, or is there something I can do to make the experience less scary (for myself and for him)? I would love to hear about other parents' (or doctors' or psychologists') experiences with an infant's surgery, particularly if it involves the same medical conditions (or the same surgeon . . . Dr. Betts at Children's Hospital). Thank you for reading!

Hello, My son had surgery for an undescended testicle when he was 1.3 yrs old at Kaiser in SF. The doctor assured us he would not remember any of it and a year later, that seems to be true. They say long memories start forming at 2.5 to 3 yrs. It was scary to imagine him unconcious but I knew that it just had to be done. They allowed me to carry him into the operating room and hold him on my lap while they put the gas mask on him. In the weeks prior to this, they would let him play with the same mask at the office so he would't be frightened of it. He quickly fell ''asleep'' and they took him over to the table. That was the only time I really choked up. However, the surgery only took about 2 hours total and we were both there when he woke up. He slepted on the car-ride home and was running around later that day like nothing happened. He did get an infection in the incisision area a couple weeks afterwards, (it's right were the diaper goes over his waist). I think it was our fault for not putting a bandage over it and giving him a bath too soon. I would just wipe him down for 2 weeks and keep that area dry. Good luck! Amy
Hi, we went through the same experience with our infant son (who is now almost 13). In fact, he ended up having to have two surgeries -- one for each testicle. The first surgery was at about 12 months, the second about 18 months. He has no memory of the surgery or of even being in the hospital. My son knows about it, because there is a tiny faded scar (from a staple or incision?)on one of his testicles. He pointed the scar out to me when he was around 8. We told him in practical terms that they had brought his testicles down because they got stuck inside, and he didn't see it as a big deal. More a point of interest.

[Bilateral descended testicles does have serious fertility implications and other statistical correlations to hormones and other stuff. Going on medline freaked me out at the time (he was only a baby!). But we have not shared this with out son, because medical stuff, esp. fertility, always evolves.]

The surgery was much harder for us as parents. We were so upset and anxious inside; my son seemed ok. The hardest part will be right after the surgery, when he cries out for you and seems so vulnerable. But he will bounce right back in a couple days -- or less -- right before your eyes. Hope this helps, Been There And It's Fine Now

My son saw Dr. Betts for a circ revision,....he also had too little foreskin taken off. I wasn't thrilled with the entire procedure. First they had us waiting three hours. Apparently the doctor was late and they didn't bother telling us. We were told not to give him anything to eat and no liquids after a certain time. My poor son (10 months at the time) was starving and cranky at waiting so long and I couldn't even nurse him. When we finally saw Dr. Betts, he never even apologized for having us wait. He always seemed very rushed and never took the time to discuss basic things that all the nurses assumed he told me already (how to care for it afterwards, etc). After the surgery my son's penis looked normal, but then two weeks later it seemed to ''grow back over'' and I had to keep pulling the skin back to see the tip. I was concerned about it and called the doctor. He never returned my call and finally a nurse tracked him down for me and left me a message saying that dr. betts was in a rush but said very quickly to her that it ''was normal''. Not the most confidence inspiring response for a worried mom. He didn't even see my son! I really was about to walk out on the surgery when dr. betts was three hours late. The only reason I didn't was because a pediatrician friend of mine said he was supposedly one of the best pediatric urologists. In retrospect I would have gone with someone else,...a less experienced doctor might have been more thorough and more sensitive to our needs. Good luck. Unhappy Mom
At first I didn't see your original posting (I don't always read all of them) but after reading the negative review of Dr. Betts, I went back to find it. My son had an undescended testicle and had surgery with Dr. Betts when he was 15 months old. I must say that on the morning of the surgery, everything went very smoothly. The nurses checked and double-checked. I too was worried about how he would do without anything to eat, but it was necessary to keep him on an empty stomach due to the effects of anesthesia. When I voiced my concerns about his not being able to eat, the nurses gave me ideas to keep him distracted so he wouldn't get too cranky. The morning of the surgery, there was so much going on, I think he forgot he was hungry.

After the surgery began, my son's case was more complicated than expected. He had a crossed, fused, right to left sided testicular transposition. In other words, the right testicle was for some reason on the left side, so Dr. Betts had to free it from the left side and bring it over to the right. Let me emphasize that this is an extremely rare case and will probably be published in medical journals. As soon as Dr. Betts was able to, he left the surgery room, called us in, explained everything to us face-to-face, and cancelled all other appointments for that day. As the surgery continued, (It took several hours) he kept us up-to-date through his nurse, who came down personally to tell us what was going on. In the end the surgery was successful and I feel blessed that we have such an expert right here at Children's Hospital.

What should have been a simple surgery ended up being a 5-day stay in the hospital. Dr. Betts came everyday, saw my son even on Sunday, and always answered my questions. Betts was careful to monitor his progress extremely carefully, taking my son step- by-step through the recovery process. We saw Dr. Betts a few days later, a week later, a few weeks later, a month later, then every six months. My son is now 31/2 and sees Dr. Betts for yearly check-ups. He is always friendly, answers all my questions. The nurses are helpful also.

As for the psychological impact on my son, I truly think he was too young to remember anything. Your biggest challenge may be to manage his pain after the surgery, but the pain management doctor may be able to give you tips on that.

I hope this helps. Dr. Betts is truly a master at what he does and I feel so fortunate he was working on my son that day.

Betts Fan

Alternative to surgery for 2-year-old's undescended testicle?

June 2003

Does anybody know of alternatives to surgery for treating partially descended testicles (it's sitting stuck in the muscle at the top of the sac). The kid is just 2 year old.

Hi, I don't have specific knowledge about alternative treatment for undescended testicles. However, I wanted to share our experience around our son to reassure you. Ten years ago he was born with bilateral undescended testiciles. He had surgery at 1 and 1/2 years and 2 and 1/2 years, to bring each of them down, at Children's. The surgery was much harder on us as parents than for him. He has no memory of the surgery at all. And, according to the doctors at the time, the surgery enhanced the fertility possibilities for adulthood (there's a high infertility rate when both testes are undescended). We wish you the best in dealing with this unexpected challenge; it will be a memory in the years to come. Been There
Very high malignancy rate associated with undescended testicles. If this were my son I would go see a urologist--Joel Piser, M.D. (Berkeley) is very good and treats both adults and children. Please take care of this. Mom M. Momma Doc
Please take care of this with surgery asap if you can. My nephew was born with one undescended testicle, and his parents decided to see if it would drop on it's own. When he was 11, he had to have the testicle removed with surgery because it shriveled up instead of dropping. It would have been better if they had just had it taken care of while they could have. anon

Worried that 11-year-old's testicles haven't dropped yet

May 2002

Recently my husband commented that he didn't think our 11 year old son's testicles had dropped yet. My comment was something like ''huh?'' This is not something I've ever thought about. He had a medical check up last Sept and our pediatrician didn't comment or have any concern (after checking his genitals). Since my husband commented on this I've noticed that my sons penis and scrotum area seem very small. He's getting to the age of being self conscious about being naked or looked at even by me so I don't feel like I can really check it out. Would I even really know what I'm looking for? My question is....is there an average age when the testicles drop? Is this something every mother should know about? What if they haven't dropped within the realms of an average age...what does that mean? What would one do about it? Thanks for any info. Anonymous please.

Please get your son's testicles examined as soon as possible. I know a boy who had one testicle that hadn't dropped by age 10 or 11 -- over time it shrivled up and had to be removed. Anonymous
My guess is that if no one (pediatrician, whoever attended his birth) has ever mentioned to you that your sons testicles haven't come down, then they probably have. Undescended testicles can cause problems if they haven't dropped by about age 5, most notably they are at a significantly increased risk for testicular cancer. But that is why they are checked (or should be) at every doctors visit from birth. You may just want to call your pediatrician and ask him or her if both testicles have been felt -- it should be noted in your sons chart. Tara