What are ectopic testes?

An ectopic testis is a type of ectopia, where an organ, or a part of an organ, is in the wrong place within the body. An ectopic testis is where one of the testicles has not descended into the scrotum as normal, but instead has taken a different path and has descended through the abdominal cavity until it has settled in the pre-pubic area in the inguinal canal, instead of in the scrotum.

The difference between ectopic testes and cryptorchidism (undescended testicle) is that in the latter case, the testicle has not descended completely, so it is not in its normal position within the scrotum either.

What is the prognosis?

Ectopic testes are the most common genital malformation in children, occurring to a greater extent in children who are born prematurely. In many cases, the ectopia cures itself without needing treatment. This development will depend on how high the position of the testicle is and whether it occurs in a single testicle or in both testicles.

If the testicle does not descend naturally and is not treated, this can later affect fertility. At the moment, there are very few cases whereby the ectopic testes are maintained after the first year of life, but the important thing is to treat the anomaly in time so that fertility is not affected.

What are the symptoms of ectopic testes?

Ectopic testes do not show related symptoms, but the absence of one or both testicles is immediately noticeable in the baby, due to their empty scrotal sac. When parents detect any irregularity of this type, they can go to a paediatrician's practice to get a diagnosis.

Ectopic testes are usually corrected in the first year of life, but if this does not happen, it will require surgical treatment.

How are ectopic testes diagnosed?

This genital malformation is diagnosed by physical examination, and further tests are usually not necessary. It is usually detected in the first visits to the paediatrician, who will touch the scrotal sac carefully to detect the position of the testicle. After the first year of the baby's life, a scan will be performed again to see if the testicle has been placed in its correct position.

What are the causes of ectopic testes?

Ectopic testes are a symptom of a congenital malformation syndrome, which can be caused by congenital endocrine abnormalities during pregnancy.

Can ectopic testes be prevented?

There is no way to prevent this genital malformation. The testicles develop during pregnancy, and at birth may not have been placed in their correct position. There is a higher prevalence in premature babies.

How are ectopic testes treated?

At the age of one, the paediatrician will examine the baby to check the position of the testicles: if you can feel the testicle when you touch it, even if it is not in its correct position, it is not a problem due to the fact that the testicle will normally descend and be placed into its correct position during puberty.

However, if you cannot feel the testicle, it means that it remains hidden in the abdominal area. In this case, the necessary treatment would be laparoscopic surgery to place the testicle in the scrotum.

Which specialist treats ectopic testes?

A paediatrician is the specialist in charge of detecting this anomaly. Also, if there is a need for surgical treatment, a paediatric surgeon will perform it. In case the problem has not been treated in childhood, an adult should go to a urologist to know what treatment options are available to them. 

What are the main risk factors?

Newborn babies are at an increased risk of suffering from ectopic testes if:

• they have a low birth weight
• they are born prematurely
• they experience any other genital development problems or disorders
• the mother consumed a lot of alcohol during pregnancy
• the mother smoked during pregnancy or was regularly exposed to second-hand smoke

What are the main complications associated with ectopic testes?

Apart from the previously mentioned complication of infertility, there are other complications related to ectopic testes. These include: 

• testicular cancer
• testicular torsion
• testicular trauma
• inguinal hernia