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In young boys a retractile testicle is a testicle that moves between the groin and scrotum. This may seem alarming but it's not a health risk. The testicle most often moves back down into the scrotum on its own, but sometimes may require a painless move by the hand. Most boys grow out of retractile testicle.
Of the adults with retractile testis, 2 of 7 (28.5%) were normal, 3 of 7 (43%) were oligoasthenozoospermic, and 2 of 7 (28%) were azoospermic.
Usually, a retractile testicle will resolve itself naturally during puberty and remain in the scrotum throughout adulthood. Occasionally, a retractile testicle cannot be moved back from the groin to the scrotum; this is called an ascending testicle. A retractile testicle is often caused by an active cremaster muscle.
In most cases no treatment is necessary, as the testicles will usually move down into the scrotum naturally during the first 3 to 6 months of life. But around 1 in 100 boys has testicles that stay undescended unless treated.
The cremaster muscle can contract inside the body causing the testicle to be pulled in and out of the scrotum; this is called the cremasteric reflex. This is a normal reflex seen in all males. The reflex can be elicited by cold, fear or a light touch to the inside of the thigh.
Fertility and Sterility, 83, 1581-1584. Caucci, M., Barbatelli, G. and Cinti, S. (1997) The Retractile Testis Can Be a Cause of Adult Infertility.
If the testicle can be easily brought into the scrotum and it remains there once released without tension, the testicle is considered retractile. Surgery is not typically recommended for retractile testicle but the child should be examined yearly to assess the condition.
In most cases, retractile testicles will relax into the scrotum permanently during puberty (between the ages of 12 and 16 for boys).
A retractile testicle is due to a muscle reflex in the scrotum. An ascending testicle, which has returned to the groin. The testicle can't be easily guided by hand into the scrotum. Another name for this is an acquired undescended testicle.
Treatment for these spasms ranges from minor surgery to injection with Botulinum A toxin to the regular application of heat to relax the muscle. Surgery, including the excision of the cremaster muscle, has apparently been able to provide complete relief from this condition without significant side effects.
Ascending testis (AT) is one of the rare but serious complication that may occurs following inguinal hernia/hydrocele repair.
In most cases, if the testicle can be felt in the groin, a simple orchidopexy can be performed. This involves first making a cut (incision) in the groin to locate the undescended testicle. The testicle is then moved downwards and repositioned in the scrotum through a second incision.
Most men's testicles are about the same size, but it's common for one to be slightly bigger than the other. It's also common for one testicle to hang lower than the other.
The cremaster reflex results in a contraction of this muscle which allows the testicle to rise upwards. A hyperactive cremaster reflex; however, can pull the testicle up far too high into the groin, and men with this condition may have to actually push the testicle back down to the scrotum which may result in pain.
Context: Undescended testes at birth may be caused by testosterone deficiency during fetal development.
Retractile testicles don't require surgery or other treatment. A retractile testicle is likely to descend on its own before or during puberty.
When testicles are not palpable, are unable to be brought to the scrotum, or do not remain in the scrotum by 6 months of age, a referral to a pediatric urologist is recommended for evaluation of an undescended testicle. Retractile testicles can be brought down to the scrotum and will remain there.
NOTE that both squatting and the `chair test' where the knees are pulled up against the chest and the patient is examined relax the cremaster muscle allowing a retractile testis to be manipulated into the scrotum. The cremaster reflex is absent in the newborn and maximum at age 7-8 years.
Your Child's Recovery
This is usually in 2 or 3 days. Your child may also have pain, swelling, or bruises in the groin area. Medicines can help with pain. Swelling or bruising should start to go away 2 to 3 weeks after surgery.
Testicular ascent, while uncommon, can occur. A testicle that has ascended out of the scrotum can torse and may present as an acute inguinal mass or acute abdomen.
Symptoms of hernias that go back and forth include: A bulge that increases in size when you strain and disappears when you lie down. Sudden pain in your groin or scrotum when exercising or straining. A feeling of weakness, pressure, burning, or aching in your groin or scrotum.
A hernia will be apparent if there is a soft bulge in either the inguinal area (the crease between the abdomen and the top of the leg) or in the scrotum. A hernia that occurs in the groin area is called an inguinal area. Part of the abdominal contents, such as intestines, can be pushed through this opening.
Fortunately, there is a very effective minor surgical treatment known as a microsurgical subinguinal cremaster muscle release, which releases this muscle to prevent this vigorous testicular retraction.