Patient discussions
Patients can be informed that the two main functions of the testicle are testosterone secretion (not affected by the testis being out of the scrotum, but possibly impaired in the future) and sperm production (impaired when the testis is not in the scrotum). Consequently there are three main reasons for surgically moving an undescended testicle into the scrotum:
Fertility: boys with only one testicle in the scrotum have almost the same chance of having children as boys with both testicles in the scrotum (about 90% vs. 94%).[76][115] One normal testicle usually produces enough sperm on its own. In boys with both testicles undescended, fertility is reduced to a 33% to 53% chance. However, advances in infertility treatment are improving these odds.
Reducing the risk of cancer: boys born with an undescended testicle have an increased risk of testicular cancer, usually occurring from puberty up to 40 years of age. The risk of a boy with an undescended testicle having cancer is about 3.7 to 7.5 times that of a boy with two descended testicles.[123] Approximately 5% of testicular cancers are associated with cryptorchidism.[98] If the testicle is brought down into the scrotum in the first 12 to 18 months of life, the risk of cancer goes down, but it is still more than that of a boy with descended testicles.[114]
Cosmesis: most boys wish to have both testicles in the scrotum. Even though there is an increased risk of cancer, that risk is generally low enough that it is better to bring the testicle down into the scrotum rather than remove it, for cosmetic reasons.
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