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A retractile testicle is a condition where the testicle moves back and forth between the groin and the scrotum, which is the sac located beneath the penis. During a physical examination, the testicle can be easily guided by hand into its proper position in the scrotum when it is residing in the groin. After being released, the testicle will temporarily stay in the correct position.
In most cases, the issue of a retractile testicle resolves itself naturally before or during puberty. The testicle moves to its appropriate location in the scrotum and remains there permanently.
However, there are instances where the retractile testicle stays in the groin and cannot be moved. In such cases, the condition is referred to as an ascending testicle or an acquired undescended testicle.
Symptoms
A retractile testicle occurs when the testicle, which initially descended into the scrotum during fetal development, doesn’t remain in its proper position. Symptoms of a retractile testicle include:
- The ability to manually move the testicle from the groin into the scrotum, where it won’t immediately retreat back to the groin.
- Occasional spontaneous appearance of the testicle in the scrotum, where it stays for a period of time.
- Intermittent disappearance of the testicle, returning to the groin.
It is important to note that a retractile testicle should not be confused with an undescended testicle, which is one that never entered the scrotum.
During regular well-baby checkups and annual childhood checkups, the doctor examines a child’s testicles to determine if they’re descended and appropriately developed. If there are concerns about the development of the testicles, such as a retractile or ascending testicle, it is recommended to seek medical advice. The doctor will provide guidance on the frequency of checkups needed to monitor any changes in the condition.
Causes
A retractile testicle occurs when an overactive cremaster muscle, a thin pouch-like muscle in which the testicle rests, causes the testicle to be pulled up towards the body. The cremaster muscle can contract in response to stimuli such as rubbing a nerve on the inner thigh, emotions like fear and laughter, and exposure to a cold environment. If the cremaster reflex is particularly strong, it can lead to the testicle being pulled out of the scrotum and up into the groin, resulting in a retractile testicle.
Diagnosis
During a physical examination, a healthcare provider can diagnose a retractile testicle by ensuring it is not an undescended testicle. The examination can be conducted while the individual is lying down, sitting, or standing. In the case of toddlers, the doctor may ask them to sit with the soles of their feet touching and knees to the sides, as this position facilitates locating and manipulating the testicle. If the testicle is retractile, it will move relatively easily and not immediately return to its original location. However, if the testicle retreats immediately back into the groin, it is more likely to be an undescended testicle.
Treatment
There is no need for surgery or other treatments for retractile testicles. Before or after puberty, a retractile testicle is prone to descend on its own. If your son has a retractile testicle, his doctor will keep track of any shifts in its location during yearly exams to assess if it will stay in the scrotum, continue to be retractile, or become an ascending testicle.
