A retractile testicle is one that has fully descended but that can be lifted up out of the scrotum by the contraction of the cremaster muscle (cremasteric reflex), which attaches to the testicle. When a testicle is in the retracted position, it may rise as far as the superficial inguinal pouch, which is a small pocket under the skin of the groin just below the inguinal canal.
Retractile testicles usually do not occur at birth or in infants younger than age 3 months. The cremasteric reflex is strongest between ages 2 and 7 years, and retractile testicles are most common in boys who are about 5 or 6 years old. Both testicles usually retract at the same time.
A retractile testicle can be drawn down completely to the base of the scrotum during an exam and will remain there if the cremaster muscle is relaxed; an undescended testicle cannot. Retractile testicles may be mistaken for a true undescended testicle. It is important that the position of the testicles at birth and in early infancy be recorded during well baby checkups during the first year because this information can help a health professional distinguish between a retractile testicle and a true undescended testicle.
Testicles that rise up out of the scrotum in young boys who had normally descended testicles at birth are almost certainly retractile testicles. In very rare cases, a testicle that has descended normally into the scrotum will reascend. Such cases must be evaluated carefully so that they are not confused with a retractile testicle.
Retractile testicles do not require treatment. As boys reach early adolescence, the testicles enlarge and the cremasteric muscle reflex weakens, so the testicles usually descend back into the scrotum on their own. Retractile testicles appear to be otherwise normal and do not have the risks for infertility or testicular cancer that are associated with true undescended testicles.
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