Undescended Testicles

Learn what undescended/absent testes means, the common symptoms parents notice, when to seek help, and how undescended testes treatment is done in Singapore.

What Are Undescended/Absent Testes?

Undescended testes (cryptorchidism) means a testicle has not moved down into its proper place in the scrotum before birth or shortly after. In many babies, only one side is affected, but sometimes both testicles are not in the scrotum.
“Absent testes” can sound alarming, but it does not always mean the testicle is truly missing - sometimes it is simply higher up and cannot be felt during an exam. More rarely, a testis may be absent (“vanishing testis”), which is why accurate assessment and a clear plan matter.

Common Symptoms of Undescended/Absent Testes in Children

Many children have no pain, and parents often notice the issue during diaper changes, bathing, or routine checkups. Common signs include:

One or both testicles cannot be felt in the scrotum.
A scrotum that looks smaller/flatter than expected (especially if both testes are not down).
A scrotum that looks uneven or lopsided (often when one side is affected).

When to Seek Evaluation

A child should be evaluated if a testicle is not in the scrotum, especially if it still hasn’t come down by about 6 months of age (corrected for prematurity). Older children should also be checked if a testicle that was previously in the scrotum seems to have “gone missing,” because some testes can move upward over time.

What Causes Undescended/Absent Testes in Children?

Testicular descent is a normal developmental process, and sometimes it is incomplete, leaving the testis outside the scrotum (cryptorchidism). Premature birth increases risk because descent often happens later in pregnancy.
In a smaller group of children, the testis may be truly absent (“vanishing testis”), and this can present similarly to a non-palpable undescended testis, so a specialist assessment is important.

Consequences of Undescended/Absent Testes in Children

Parents often wonder whether it is safe to wait; however, an undescended testis left outside the scrotum for too long can affect future fertility potential. There is also an increased long-term risk of testicular cancer compared with boys whose testes descended normally, and successful scrotal repositioning may reduce (but does not completely prevent) that risk.
Undescended testes can also be associated with an inguinal hernia, and timely surgery helps address these risks and makes future examination easier.

How to Treat Undescended/Absent Testes in Children

Initial Evaluation And Diagnosis

Undescended test treatment starts with a careful physical examination to check whether the testis is palpable and where it may be located. Imaging (like ultrasound) is generally not recommended before referral because it rarely changes management and can delay the right treatment.
If the testicle has not descended by 6 months of age (corrected for prematurity), referral is recommended, and surgery is typically planned in early childhood based on specialist assessment.

Orchiopexy Paediatric Surgery (Undescended Testicles Surgery)

For most children who need treatment, the main option is orchiopexy, paediatric surgery, also called the cryptorchidism orchiopexy procedure. This operation relocates the testis into the scrotum and secures it there, which supports long-term monitoring and may lower future risks.
Parents sometimes search for terms like “hidden testicle operation” or “undescended testicle surgery” - in many cases, these refer to orchiopexy, though the exact approach depends on whether the testis can be felt or is non-palpable.

What to Expect on the Day of Orchiopexy and Recovery

Most children can go home the same day after orchiopexy once they are comfortable, drinking/eating, and have passed urine. Mild bruising or swelling around the groin/scrotum can occur and may take days to weeks to settle.
Activity is usually limited for a short period - families are commonly advised to avoid straddle activities (like bicycles) for a few weeks, and the surgical team will give specific guidance based on the operation performed.

Why Choose The Little Surgery for Undescended/Absent Testes Treatment

Dr Ong Lin Yin is an experienced paediatric surgeon at The Little Surgery, and she was a senior consultant and former Head of Department of Paediatric Surgery at KK Women’s and Children’s Hospital (KKH). Her background includes long-term dedication to paediatric surgery and urology, which is especially relevant for conditions like undescended/absent testes.

Experienced Paediatric Surgeon

Dr. Ong Lin Yin brings over 20 years of experience in paediatric surgery at KK Women's and Children's Hospital, including extensive experience evaluating symptoms that may require procedural or surgical decision-making. This experience is valuable when rectal bleeding could reflect anything from fissures to polyps or inflammatory bowel conditions, helping families move quickly from symptoms to a clear plan.

Comprehensive Care

The Little Surgery provides paediatric urology care for disorders of children’s genitourinary systems, supporting evaluation, treatment, and follow-up in one coordinated journey. The care approach also aligns with guideline-based practice - timely referral, focused examination, and avoiding unnecessary imaging that may delay treatment.

Family Support

The clinic’s approach emphasises guiding families step-by-step - from assessment to treatment to recovery - so parents feel informed rather than overwhelmed. Many parents feel anxious when they hear “undescended” or “absent,” and clear explanations and a practical plan can make a big difference during decision-making.

Contact The Little Surgery Today

If you’re concerned that your child’s testicle cannot be felt in the scrotum or the scrotum looks uneven or underfilled, an early assessment can provide clarity and options.
Contact The Little Surgery today and take the first step toward ensuring your child's health and happiness.