Does your baby boy have one testicle bigger than the other?

Does your baby boy have one testicle bigger than the other?

Researchers have linked this condition with health issues later in life, including cancer and infertility.

Parents, while rejoicing over the successful birth of  your baby boy, you might overlook one simple detail. Did you notice one testicle larger than the other in baby? The condition is called an undescended testes in babies, and should be checked soon. All the more reason, too, because research has found a correlation between undescended tesiticles in boys and a concerning health condition later in life.

But first…

One Testicle Larger Than the Other in Baby Boy: A Case of Undescended Testes in Babies

Undescended testes in babies is actually a common condition, occurring in one out of a hundred newborn baby boys. Moms who give birth to baby boys may recognize the condition when their newborn sons appear to have one or both testicles missing from their scrotum.

This odd condition happens because the testicle doesn’t grow outside. Rather, it develops in the abdomen first while the baby is still in the womb. Undescended testes in babies happen when the testicle doesn’t properly grow out of the body – leaving baby boys with only one or no testicles at all.

Approximately 50% of all affected newborn baby boys will have their testicles “descend” into their scrotums. Others might be a couple of months behind schedule. But for babies whose testicles don’t descend at all, it could spell increased risks of other serious issues as they grow up.

Now a new study led by University of Sydney researchers has warned that delaying surgery to fix the problem can put boys at heightened risk of serious health problems as they grow into adulthood.

Effects of Not Treating Undescended Testes in Babies

Recently, researchers from the University of Sydney conducted a study about undescended testes in boys.

After analysing data from over 350,000 boys born between 1970 and 1999, they discovered some shocking facts. The boys who experienced undescended testes:

  • were two and a half times likelier to suffer from testicular cancer
  • reduced their chances of conceiving children by 20%
  • required assistance about two times as much as their normal counterparts to care for infertility

Why does this happen? Well, to produce sperm, testicles need to be colder than the internal body temperature. That’s the main reason why they have to dangle outside of the body.

However, remember that in boys with undescended testes, their testicles stay inside the body. Current theories suggest that because these testicles are heated to internal body temperatures, their sperm cells are at higher risk of genetic irregularities and cell injury.

Over time, these conditions could accumulate and cause testicular cancer and infertility issues.

Does your baby boy have one testicle bigger than the other?

When Should Undescended Testes in Babies Be Treated?

International guidelines have always suggested surgeons to perform a surgery known as orchidopexy while the baby is still 18 months old.

An orchidopexy is a procedure where doctors move and secure the undescended testicle in the scrotum.

However, researchers have found that many surgeries don’t happen in this time frame.

Professor Natasha Nassar is a senior author who was part of the study. She cites that “45 per cent of boys are still having surgery after 18 months of age. I think maybe one of the issues is that people aren’t looking for it, maybe not even opening up the nappy and just checking.”

Other doctors are more comfortable doing it earlier. For instance, pediatric surgeon Professor Andrew Holland picks babies as young as six months old for the procedure.

One Testicle Larger Than the Other in Baby Boys: A Difficult Condition to Diagnose

In fact, it might not be that easy to find out if your little one has an undescended testicle.

Babies need to be periodically checked for this issue (covering the first 24 hours after birth, too). Yet, even with this, Professor Holland admits that people needed a certain measure of skill to diagnose it.

One reason why it might be so hard is that newborn testes are much smaller than an adult’s or an adolescent’s, says Prof Holland.

“And I guess there might be some potential embarrassment on the behalf of the parent or the person examining that area that makes them less enthusiastic about examining that region,” he observed.

Sometimes, there could be other reasons why testicles are absent in a newborn. These other factors also make diagnosing undescended testes harder.

For instance, sometimes the spermatic cord (which testicles are connected to) develops at a slower pace than the body’s growth. If this happens, a spermatic cord that isn’t long enough can drag the testicle back up into the body.

Moms who gave birth prematurely will also have to watch out. Premature birth is known to increase the risk of newborn boys suffering undescended testes, as they need more time to descend naturally.

one testicle larger than the other in toddler

Premature birth increases the risk of undescended testicles. | Image courtesy: Pexels

Other Baby Boy Genitalia Issues Parents Should Be Aware About

Inguinal Hernia

This occurs when abdominal tissue — such as a loop of intestine — moves into your baby’s open inguinal canal. The main symptom of this is a small, painless bulge in your baby’s groin area. These hernias are likelier to happen in boys than girls.

What to do:

In order to prevent your baby from developing a strangulated hernia which is “a condition that occurs when a piece of intestinal content gets stuck in the canal and cuts off the blood supply to that portion of the intestine,” your doctor may recommend minor surgery to close up the inguinal canal.

What happens if a strangulated hernia does develop? Your baby will experience a hard, swollen and very painful lump in his groin area that needs immediate medical treatment.


“When a boy’s inguinal canal fails to close, fluid from the abdomen can collect in the scrotal sac,” says Dr Steven Tennenbaum, a New York-based paediatric urologist. It causes your baby’s testicles to appear swollen, but isn’t painful.

one testicle larger than the other in toddler

What a hydrocele looks like from the side. | Image source: stock photo

What to do:

A hydrocele will usually go away on its own. But if it doesn’t, then your baby’s doctor may recommend surgery after the first birthday to get rid of the fluid and close the passageway.

Urinary Tract Infection (UTI)

A UTI can occur if your baby’s penis is not cleaned properly. It is caused by an overgrowth of bacteria. Usually, the only symptom of UTIs in babies is high fever.

But sometimes, you may notice odd-smelling urine, unusual irritability in your baby or even vomiting. If you notice any of these symptoms, please consult your baby’s paediatrician without delay.

What to do:

A course of antibiotics will easily treat a UTI, according to doctors.

Penile Adhesion

This sometimes occurs after circumcision. When body tissue is cut, the edges can stick the the area around the cut. Raw areas of the foreskin may stick the glans, or head of the penis.

If this happens, it may look like the penis was never circumcised, or like the glans is covered by a thin film.

What to do:

A penile adhesion is painless and will almost always correct itself as the penis grows. No treatment is needed. However, if the adhesions are extensive, a mild steroid cream may be prescribed, says Dr Victoria McEvoy, assistant professor of paediatrics at Harvard Medical School.


References: The University of SydneySydney Morning Herald

Also Read: 

Why it’s normal for kids to touch their genitals

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