Retractile testicle is a subtype of undescended testicle but is not a true undescended testicle. While true undescended testicle is a condition that must be treated, it is sufficient for retractile testicle to be followed by urologists.
Retractile testicle is a condition known among the public as shy testicle, in which the testicle sometimes escapes into the groin, but can also go down and remain in the testicle sac, which we call the scrotum.
Since the pathology, popularly known as retractile testicle, is common in children, it is frequently researched on search engines and platforms, especially by mothers.
There are also fiber structures called cremasters in the cord structure of the testicle, which contains the vascular and sperm structures. These fibers contract during moments that cause contraction in the smooth muscles, such as cold, excitement, or fear, and pull the testicle upwards. This can happen in physiologically normal testes and in shy testes.
Being permanently inside is a pathology and is caused by the fibers being overly tense, the cord structure being short, and the gubernaculum settling into the scrotal sac without descending. Gubernaculum is the structure that guides the testicle to descend into the scrotal sac during embryological development.
First of all, every parent and the pediatrician who follows the child should be aware of undescended testicles. When there is a suspicion that the inside of the scrotum (ovarian sac) is empty, it is necessary to consult a urologist for examination. Examination by experienced hands to distinguish the shy testicle from the true undescended testicle is essential and sufficient for diagnosis. In the shy testicle, unlike the undescended testicle, the testicle descends into the scrotum (sac) easily and remains there for a while. In addition, shy testicle is a benign condition and does not cause infertility or cancer.
The most important symptom of escaping testicle is the family's inability to touch the testicle in the scrotum. Sometimes, because the sac is empty, it may seem small compared to its symmetry.
It is thought that the cremaster reflex, which causes the testicle to move upward due to factors such as fear, excitement and cold weather, which is also seen in normal children and adults, is more active in these children and occurs due to these hyperactive muscles.
If retractile testicle is well monitored and intervened in time, it does not pose a serious risk for testicular cancer and infertility like other undescended testicle subtypes.
Most of the retractile testicle recovers in the first years of life. This rate is around 98% in adolescence. However, ascending testicle, which does not improve and is located above, requires surgical treatment (orchidopexy).
Most of the shy testicles spontaneously descend and settle into the scrotum (sac) as children grow, and this period may last until adolescence. It usually resolves on its own without the need for surgery. However, a small part of it, called 'assending', settles in the groin instead of the scrotum and requires surgery.
There is not enough scientific data to show that shy testicle impairs spermatogenesis (sperm production) like other types of undescended testicles. However, it is thought that shy testicles that are not monitored well and not intervened in time may also cause infertility.
If you think your child has shy or undescended testicles, you should definitely consult a urologist. Undescended or shy testicle is a pathology that should not be neglected, although its treatment is simple and its consequences can be serious.
If intervention is needed during follow-up of retractile (shy) testicles, it must be treated with surgical intervention, just like other types of undescended testicles. Drug treatments used for a while are no longer recommended because their success rate is very low.
Drug therapy has no place in the treatment of both undescended testicles and retractile, escaping testicles. If necessary, fixation is made by surgery.
The probability of developing shy (retractile) testicles in adults is very low. This is more likely to be a true undescended testicle, and since this tissue may become cancerous in adulthood, surgical intervention is necessary and follow-up is not performed.
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