In all male newborns, the testicles should be reliably detectable in the scrotum shortly after birth. In some (especially premature) children, however, it can take several weeks or months for the testicles to reach the scrotum. This is because the testicles are initially laid in the abdomen in the womb and only slowly migrate through the so-called inguinal canal into the scrotum during the course of the pregnancy. They must have demonstrably arrived here by the end of the first year of life. If this is not the case, there are three possible situations:

The testicle can be felt from the outside in the groin. It can be pushed or pulled into the scrotum without significant resistance and remains there. In this case, it is a so-called pendulum testicle, which must be checked regularly by the pediatrician and the parents. Treatment is not necessary.

The testicle can be felt from the outside in the groin. However, it can only be moved into the scrotum under tension and immediately slides back towards the inguinal canal (as if pulled by a "rubber band"). This is a so-called sliding testicle, which should be surgically moved into the scrotum by the end of the first year of life at the latest.

If no testicle can be felt on one or both sides despite a detailed examination, there are basically 2 reasons: either the testicle has already perished unnoticed before birth or it has "got stuck" in the abdomen on its way towards the scrotum before reaching the inguinal canal. In either case, surgical treatment is necessary. First of all, a laparoscopy is used to determine whether a testicle is actually present on the side in question. To do this, the pediatric surgeon makes a small incision in the navel through which a thin tube (trocar) is inserted into the abdominal cavity. Air is blown into the abdominal cavity through the trocar and a camera is inserted (laparoscopy). This allows the entire abdomen to be inspected. If the testicle in question is still in the abdominal cavity, additional working channels (trocars) may be inserted into the abdomen via two or three 3mm-long incisions and the testicle detached from the surrounding tissue (mobilized). In most cases, it is still not possible to move the testicles into the scrotum because the blood vessels supplying the testicles are not long enough. To make this possible, a special surgical technique was developed (Fowler-Stevens operation). In this technique, the larger blood vessels supplying the testicles are severed. As a result, smaller blood vessels that run along the spermatic cord take over the blood supply and in 75% of cases enable the testicle to be supplied with blood. This is then moved to its correct position in the scrotum in a second operation.

In healthy children, the surgical treatment of undescended testicles is also performed on an outpatient basis. The day of the operation is only preceded by a separate appointment in our outpatient clinic. Your child will be examined on this occasion. If an operation is necessary, a comprehensive and detailed explanation of the planned procedure will be given. The consultation with the anesthetist should also take place on this day. For the planned operation, you and your child should come to the pediatric surgery department on an empty stomach. From there, your child will be taken to the operating theatre, while the accompanying person can wait in the ward lounge. After the operation, your child will initially remain in the recovery area, where you will be able to sit at the bedside again. After a recovery period on the ward, your child will be discharged depending on how he or she is feeling, but at the latest in the early afternoon.

It is not usually necessary to return to us for a follow-up examination. As we only use stitches that dissolve on their own, the post-operative check-up will be carried out by your pediatrician. However, if any questions remain unanswered or if we consider a follow-up examination to be appropriate in individual cases, you can come back to us at any time.

Special forms of undescended testicles (e.g. abdominal testicles) or patients who have already undergone surgery on the groin or testicles or who have certain pre-existing conditions require an individual treatment plan, which may differ from the outpatient procedure described above. In these cases, we will coordinate the treatment plan with you and your paediatrician. We do not recommend pre-treatment by administering hormones, as the effectiveness of this expensive therapy, which is fraught with side effects, has not yet been proven. The argument that hormone treatment makes surgery easier to perform cannot be substantiated and is therefore not supported by us.