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Retractile Testis - Causes, Symptoms, Diagnosis, and Treatment

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A testicle that retracts between the groin and the scrotum is known as a retractile testicle. Check out the article to know more.

Medically reviewed by

Dr. Raveendran S R

Published At November 9, 2022
Reviewed AtNovember 9, 2022

What Is a Retractile Testicle?

A retractile testicle is one that moves between the groin and scrotum (the sac underneath the penis). A retractile testicle does not pose a severe health problem. This condition can occur in young boys. However, the retractile testicle usually gets resolved by puberty.

What Causes Retractile Testis?

Retractile testicles are caused by the testicle moving in and out of the scrotum as a normal response to a stimulus (a reflex). For example, cold, fear, or a little contact with the inside of the thigh might elicit the reflex. Certain children may exhibit a stronger cremasteric reaction than adults. The testicles are attached to a group of muscles called the cremaster muscles that allow them to move in and out of the scrotum. The muscles contract and pull the testicles briefly out of the scrotum, causing retractile testicles. There is no known reason why certain males exhibit an increased cremasteric reaction. There are, however, several risk factors for a retractile testicle which can be:

  • Low birth weight or preterm birth.

  • Testicular retraction or other genital abnormalities are already present in the family.

  • Down syndrome or another birth condition that impairs growth and development.

  • Alcohol or drug consumption and smoking during pregnancy.

What Are the Symptoms of Retractile Testicles?

Generally, there are no symptoms shown in boys with retractile testicles, and this condition does not cause any kind of discomfort. Testicular retraction is typically limited to a single testicle. Additionally, it is usually painless, which means your child may be unaware until the retractile testicle is no longer visible or felt in the scrotum.

How Is a Retractile Testicle Diagnosed?

The physical examination is the first step in diagnosing testicular retraction. The physician may notice that one or both testicles are undescended.

  • Suppose the testicle can be readily and painlessly pulled down into the scrotum and remain there for an extended period. In that case, the doctor may safely classify the condition as a testicular retraction.

  • If the testicle can be moved into the scrotum just partially or if movement causes pain, the diagnosis may be undescended testicles.

  • Occasionally, retractile testicles are confused with undescended testicles (when one or both testicles do not correctly descend into the scrotum during development), but they are not the same.

What Is the Treatment for Retractile Testicle?

In the majority of cases, testicular retraction does not require therapy. The problem should resolve by the time puberty begins, if not sooner. Until the testicle completely drops, this is a condition that should be checked and examined annually by a physician.

  • If a retractile testicle becomes an ascending testicle, surgery may be required to permanently relocate the testicle into the scrotum. Orchiopexy is the term used to describe the operation. During the process, the surgeon separates the testicle and the spermatic cord, which is linked to and protects the testicle from any surrounding tissue in the groin. After that, the testicle is inserted into the scrotum.

How to Support a Child With a Retractile Testicle?

As the kid grows older and gains a better understanding of the body, he may develop a sense of self-consciousness about his appearance. In order to assist the child in coping with this situation, the following steps should be taken:

  • Discuss the scrotum and the testicles.

  • Explain what a retractile testicle is in simple terms.

  • Remind him that he is in perfect health and there is nothing wrong, and the condition can be treated.

  • Teach the child how to conduct self-examinations of his testicles. Instruct him to feel softly around the scrotum. When having a warm shower, the scrotum will hang slightly lower. Inform him that if he detects any changes in his testicles, he should notify them.

What Are the Possible Complications Associated With Retractile Testicles?

For the majority of boys, the problem of a retractile testicle resolves itself prior to or during puberty. The testicle repositions itself in the scrotum and remains there indefinitely. In less than five percent of cases, the retractile testicle remains immobile in the groin. This is referred to as an ascending testicle or acquired undescended testicle. This can cause further complications like:

  • Infertility.

  • Trauma.

  • Cancer.

  • Torsion and other related malformations.

  • Inguinal hernia are all more prevalent.

When Should You Seek Medical Help?

The doctor will inspect testicles during routine well-baby exams and annual childhood checkups to assess if they are descended and appropriately formed. Consult the doctor if the parents suspect that the child has a retractile or ascending testicle or if there are any other worries about the testicles' growth. The physician will advise on the frequency of checkups necessary to monitor for changes in the condition.

Is a Retractile Testicle Associated With Infertility?

  • A recent study done in Karachi, Pakistan, between the age group of 18 to 40 years, reveals that bilateral retractile testis could be a risk factor for infertility due to retraction affecting sperm motility.

  • In order to produce sperm, the testicles must be two to three degrees lower than the average body temperature. The scrotum is many degrees cooler than the rest of the body, making it a suitable location for the testicle. Testicles that do not fall into the scrotum will not function properly. The longer the testicles remain excessively heated, the less likely the sperm in those testicles will mature normally. This condition can result in infertility, particularly if both testicles are involved.


Although testicular retraction may cause concern for new parents, it is typically a harmless condition that resolves on its own. Consult the infant or toddler's pediatrician if parents are unsure what to look for. Discuss the timing, risks, and benefits of surgery with the doctor if a retractile testicle does rise permanently. The more information obtained from the child's doctor, the more at ease the parents will feel about the problem and the more readily they will be able to discuss it with the kid when he is of an age to understand.

Frequently Asked Questions


What Are the Problems Caused by Retractile Testicles?

Retractile testicles usually resolve themselves during birth or before puberty. However, some of the complications resulting from retractile testicles are infertility, cancer, psychological trauma, and genital malformations like torsion and inguinal hernia, the commonest of all.


How Can Retractile Testicles Be Corrected?

Retractile testicles do not require any treatment as such. It resolves on its own before puberty or by puberty. In cases of ascending testicles, surgery is recommended. The testicle is permanently relocated into the scrotum. This surgical method is known as orchiopexy.


What Causes Retractile Testicles?

The retractile testis is caused due to the abnormal movement of the testicle from the scrotum. During reflex, the testicles change their position in and out. A group of cremasteric muscles is attached around the testicles and help move the scrotum. Retractile testicles could be due to low birth weight, genital abnormalities present at birth, impaired growth and development, or alcohol or drug toxicity during pregnancy.


What Are the Alarming Signs of Retractile Testicles?

One of the major concerns of retractile testicles is their immobility of the testicles. These are known as ascending testicles or acquired undescended testicles. This can further lead to other complications like infertility, cancer, psychological trauma, and genital malformations like torsion and inguinal hernia, the commonest of all.


Can Retractile Testis Be Cured via Surgery?

In most cases, retractile testis resolve on its own. If the testicles remain dropped inside the scrotum, further surgical intervention is required. The physician separates the testicle from the spermatic cord, which is reinserted into the scrotum. In less than five percent of cases, the surgery does not yield any benefit. Such cases can be problematic for the risk of cancer, lingual hernia, infertility, and genital malformation.


Is Retractile Testicles a Cause of Infertility?

Certain studies have pointed out that bilateral retractile testis can cause infertility. It affects sperm mobility and causes infertility. For healthy sperm production, the testicles must be two to three degrees lower than the usual body temperature. The scrotum is a little away from the body and is cooler than the rest of the body. Excessive heat in these regions can lead to a lack of maturation of sperm and cause infertility.


What Can Be Done to Relax a Cremaster?

A warm bath with the scrotum hanging slightly lower can reduce the excitability of cremaster muscles. Always touch the scrotum area with a gentle touch. In cases of extremely retractile testicles, further surgical operations are done to correct them.


Do Retractile Testicles Affect Adults?

Usually, retractile testicles present during birth resolve by the time of puberty or after that. In cases where it is not resolved, further surgical procedures are done to correct it. Only in less than five percent of adult cases it does not get resolved through surgery and causes further complications.


When Should a Urologist Be Consulted for Retractile Testes?

If retractile testicles persist even after puberty and cause other physical or emotional distress in a patient, he should consult with a urologist for further treatment. In married people, this can cause infertility. If the swelling of the testicles is too large, it can indicate a lingual hernia that requires attention at the earliest.


How Serious Is Retractile Testicle? Is It A Cause for Concern?

An untreated retractile testicle can be a concern. Especially in married men, as this can interfere with fertility. The chances of other complications also persist, such as cancer, psychological trauma, and genital malformations like torsion and inguinal hernia, the commonest of all.


What Are the Ways to Move a Testicle From the Groin to the Scrotum?

Surgery is conducted by separating the testicles from the spermatic cord. This spermatic cord protects the testicles from surrounding tissue in the groin. The testicle is inserted back into the scrotum. This surgical procedure is known as orchiopexy.


Does the Retractile Testicle Cause Pain?

There are no associated symptoms for retractile testicles. It usually affects a single testicle and does not cause any discomfort. It does not cause pain and may become invisible over time, catching males' attention due to its absence.


Is Retractile Testicle and Hernia the Same?

No retractile testicle and hernia are two different conditions. Retractile testicle affects the testicles inside the scrotum, making them drop down or making them undescended testicles. If the retractile testicle does not resolve, it can lead to a hernia. However, the hernia is caused due to weak muscle attachment, making the scrotum hang or protrude more than usual.

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Dr. Raveendran S R
Dr. Raveendran S R



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