Retractile Testis Definition, Reason, Symptoms, Treatment & Prevention
Definition
Retractile Testis is a disorder in which the testicle rises and falls between the scrotum (testicular pouch) and groin. When the testes are retractile and are in the groin, the testes can be directed by hand to return to their position in the scrotum.
In most men, Retractile Testis generally resolves on its own before or at puberty. The testes can move into their correct position in the scrotum and remain in that location permanently.
However, there are at least less than 5 percent of cases, where the Retractile Testis stays in the groin and cannot be moved again to where it should be. When this happens, the condition is known as ascending testicle or acquired undescended testicle.
Symptom
The formation of the testicles during the process of fetal development generally occurs in the abdominal cavity. In the last months of fetal formation, the testicles gradually descend into the scrotum.
If this decrease has not occurred during the delivery of the baby, generally the testicles can descend in a few months. In children with Retractile Testis, the testicles generally descend as they should – but don’t stay still in one place.
Signs and symptoms that can be observed in Retractile Testis are:
- The testicles can be guided by hand from the groin to the scrotum, and not immediately back to the groin
- The testicles may spontaneously descend into the scrotum and remain in the scrotum for some time
- The testicles may spontaneously rise to the groin for some time
Movement up and down the retractile testis almost always occurs without pain or discomfort. As a result, this condition is only realized when the testicles are no longer visible or palpable in the scrotum.
Luckily, the position of one testicle generally does not affect the position of the other. For example, a man may have one normal testicle and one Retractile Testis.
Retractile Testis is different from undescended testis (cryptorchidism). In cryptorchidism, the testes never descend into the scrotum.
Reason
Overactive muscles can cause the testicles to become retractile.
The cremaster muscle is a thin, pouch-like muscle that generally supports the testes. The main function of the cremaster muscle is to maintain a stable temperature in the testes. In order for the testicles to develop and function properly, the temperature around them must be slightly cooler than normal body temperature.
When the environment is relatively warm, the cremaster muscles generally relax. Conversely, when the ambient temperature is cold, the cremaster muscle contracts and pulls the testicles up.
The cremaster reflex can also be stimulated by several things. One of them is stimulation or subtle touch to the genitofemoral nerve in the inner upper thigh, or through several conditions that trigger certain emotions, such as anxiety. If the cremaster reflex is strong enough, the testicles can experience retractile, that is, pulling the testicles out of the scrotum and towards the groin.
Diagnosis
The diagnosis of Retractile Testis can be determined by conducting a detailed medical interview and direct physical examination. If necessary, certain supporting examinations can also be carried out.
If a person’s testicles are not located in the scrotum, a doctor can usually determine their location is in the groin. Once the location of the testicle is determined, the doctor will try to direct it to its true location in the scrotum.
If the condition experienced by the patient is indeed Retractile Testis, the testicles can be directed to the scrotum easily and without pain. After that, the testes can remain in the scrotum for some time.
Treatment
Retractile Testis can generally decrease by itself before or during puberty. In those with Retractile Testis, the doctor can monitor for changes in the position of the testicles. Evaluation will be carried out periodically to determine if the testes are permanently in the scrotum, still retractile, or settled in the groin.
If the testicles are assessed as ascending testicles, that is, the testicles rise to the groin and cannot be directed back into the scrotum, the doctor will recommend surgery to permanently move the testicles to the scrotum.
Meanwhile, if the testicles are still retractile during or after puberty, the doctor may also suggest surgery. The goal is to ensure good maturation conditions in the testes.
In this surgical procedure, known as an orchidopexy, the surgeon is able to free the testicles and cords from any tissue attachments and position the testicles in the scrotum. After this surgery, activities such as cycling and other sports should be avoided for the first two weeks.
Follow-up examinations regarding wound healing and testicular position need to be carried out within two weeks to six months after surgery. Those who have undergone a surgical procedure to repair the Retractile Testis are also advised to monitor the position of the testicles periodically. This aims to ensure that there is no further displacement of the testes to the groin.
Prevention
No prevention strategy has been proven to be completely effective in preventing Retractile Testis. However, early detection of Retractile Testis can speed up treatment and prevent complications.