Retractile testicles are caused by a normal reflex commonly found during physical exam in males. Retractile testicles are sometimes mistaken for undescended testicles, but they are not the same. An undescended testicle is not felt in the scrotum at all, while a retractile testicle is in the scrotum but can be pulled back with a muscle contraction.
Each testicle is attached to a muscle called the cremaster muscle. The cremaster muscle can contract inside the body causing the testicle to be pulled in and out of the scrotum; this is called the cremasteric reflex. This is a normal reflex seen in all males.
The reflex can be elicited by cold, fear or a light touch to the inside of the thigh. The cremasteric reflex may be more apparent in some children than others.
Boys generally do not have symptoms associated with a retractile testicle. At home, it may appear that your son’s scrotum looks empty and you cannot see the testicles. A physical exam performed by your child’s medical team will confirm the diagnosis.
Retractile testicle is diagnosed with a physical exam. During the exam it is important for your son to be as relaxed as possible. Certain positions can decrease the cremasteric reflex, such as sitting crossed-legged and squatting in a catcher position.
As long as the testicle can be easily guided into the scrotum and remain there independently, without tension, the testicles are considered retractile.
If your child has retractile testicles, he should be examined by a physician with yearly physical examinations. If there are any concerns about the position of your child’s testicles he should be seen by a urologist. Surgery is not recommended.
We may ask that your child return for another exam in one year to monitor for any changes. In some instances, a retractile testicle may become an ascending testicle. An ascending testicle occurs when the attachment of the testicle to the scrotum lengthens and the testicle is pulled out of position as your child grows.