The absence of one or both testes, also known as cryptorchidism or anorchia (when both are absent), is a condition that requires thorough evaluation in newborns and children. Normally, the testes develop inside the abdomen and descend into the scrotum before birth. When a testis is absent from the scrotum, it may be undescended, ectopic, or completely absent due to developmental abnormalities. At Dr. Pruthvi Raj Honnaiah’s clinic, a comprehensive diagnostic and evaluation process is undertaken to identify the cause and recommend appropriate management.

Causes of Absent Testis

There are several reasons why one or both testes may be absent from the scrotum:

• Undescended Testis (Cryptorchidism): The testis remains within the abdomen or groin instead of descending into the scrotum.
• Vanishing Testis Syndrome: A testis may have formed but regressed due to compromised blood supply during fetal development.
• Congenital Anorchia: Rarely, both testes fail to develop during fetal life.
• Ectopic Testis: The testis may have descended to an abnormal location outside the scrotum.
• Disorders of Sexual Development (DSD): Rare genetic or chromosomal conditions can impact testicular development.

Symptoms and Signs

While the condition is often detected at birth during routine examination, some symptoms may accompany absent or undescended testes:

• Empty Scrotum: One or both sides of the scrotum may appear flat or underdeveloped.
• Inguinal Mass: In some cases, the testis may be felt in the groin.
• Associated Inguinal Hernia: An absent or undescended testis is sometimes linked with hernias in the groin.
• Hormonal or Developmental Abnormalities: In cases of congenital anorchia, signs of incomplete male development may be present.

Diagnostic Evaluation

Accurate diagnosis and localization of the missing testis are essential for proper management. At Dr. Pruthvi Raj Honnaiah’s clinic, the following diagnostic tools are used:

• Clinical Examination: A thorough physical examination is the first step in evaluating the scrotum, groin, and abdomen.
• Ultrasound: A non-invasive imaging test to detect testes that may be located in the inguinal canal or abdomen.
• Hormonal Testing: Hormone levels, including testosterone and anti-Müllerian hormone (AMH), can provide insight into testicular presence and function.
• Laparoscopy: If the testis is not found through imaging, a minimally invasive surgical procedure (diagnostic laparoscopy) helps directly visualize the abdominal cavity to locate the testis.
• Genetic Testing (if required): In rare cases, genetic or chromosomal analysis may be done for underlying disorders of sexual development.

Treatment Options

Treatment for absent or undescended testes depends on the underlying cause, location of the testis, and the child’s age:

• Hormonal Therapy: In certain cases, hormonal treatments may help stimulate testicular descent.
• Orchiopexy (Testicular Surgery): If the testis is found outside the scrotum, surgery is performed to reposition the testis into the scrotum.
• Testicular Prosthesis: In cases of absent testes, testicular implants may be considered to improve scrotal appearance.
• Monitoring & Follow-up: Long-term follow-up is recommended to monitor testicular function, fertility, and potential cancer risk.

Importance of Early Evaluation and Treatment

Early diagnosis and management of absent or undescended testis are critical to ensure normal hormonal development, preserve fertility, and reduce the risk of testicular cancer. If untreated, cryptorchidism can lead to complications such as infertility, hernia, or testicular torsion.

Why Choose Dr. Pruthvi Raj for Paediatric Urology Care?

Dr. Pruthvi Raj Honnaiah is a renowned expert in paediatric urology, offering compassionate care and advanced diagnostic tools to address conditions like absent or undescended testes. His expertise ensures precise diagnosis, minimally invasive surgical options, and tailored treatments to support the child’s healthy development and long-term well-being.