Undescended Testis: is an ultrasound reliable?

Undescended testis is a very common condition that I frequently encounter in my clinic.

Often, children will attend with an ultrasound report stating:

“Testis in the inguinal canal – undescended testis.”

But is this always reliable?

Simple answer: No.

The diagnosis of an undescended testis relies mainly on a proper clinical examination by a pediatric surgeon. It is through examination that we can distinguish between a retractile testis and a truly undescended testis.

A retractile testis is common in young boys. The testis temporarily moves upwards out of the scrotum, but can be gently brought back down without tension.

Many things can cause this to happen — a crying or anxious child, and importantly, cold temperature.

This is where ultrasound can sometimes be misleading. Ultrasound rooms, probes and gels can be cold, causing the testis to retract upwards. The scan may then report the testis as “undescended”, when in fact it has simply temporarily retracted.

A truly undescended testis is different. On examination, it cannot be comfortably brought down and remain within the scrotum. These are the children who may require surgery to bring the testis into the correct position and protect its long-term function.

So, if your child’s ultrasound reports an undescended testis, the scan alone does not make the diagnosis.

A proper clinical examination is the most important next step.

Dr. AbdulRahman AlShafei

Consultant Pediatric Surgeon & Pediatric Urologist, Bahrain

More about Undescended Testis in Children

For more information about Undescended Testis, click here.

This article provides general information and does not replace an individual medical assessment.