What is a retractile testicle?
Retractile testicles are caused by a normal reaction to stimulation (a reflex) which results in the testicle moving in and out of the scrotum (the sac of skin that contains the testicle).
Sometimes retractile testicles can be mistaken for undescended testicles (when one or both testicles do not move into scrotum properly during development), but these conditions are not the same.
The testicle is attached to a muscle called the cremaster muscle. This muscle can contract (tense up and shorten) which causes the testicle to be pulled out of the scrotum. This is the cremasteric reflex and this movement is a normal occurrence. When the muscle relaxes, the testicle goes back into the scrotum.
Some of the things that bring on the cremasteric reflex are cold, fear or if the inside of the thigh is touched lightly. This reflex may be more apparent in some individuals versus others.
There are typically no issues like pain or trouble urinating associated with a retractile testicle. At times it may appear that the scrotum looks empty and you cannot see the testicle(s). Sometimes it is easiest to see the testicles in the scrotum when the child is sitting in a warm bath or asleep.
Testing and diagnosis
Retractile testicle is diagnosed by a physical exam. The exam is best performed when the child is as relaxed as possible.
If the diagnosis is difficult to determine while a child is laying down, it may be necessary to have the child sit up crossed-legged or squat in a catcher’s position for the exam. These positions help relax the cremasteric reflex.
If the testicle can be easily brought into the scrotum and it remains there once released without tension, the testicle is considered retractile.
Surgery is not typically recommended for retractile testicle but the child should be examined yearly to assess the condition.
In some cases, a retractile testicle may become an ascending testicle. An ascending testicle is one that once moved up and down but is now stuck in the “up” position. Surgery is typically recommended in this instance.