You should always look for the testis. About 2/3 of non-palpable testes are found in the abdominal cavity or in the inguinal canal. If a testis is present, it should be brought into the scrotum.
Laparoscopy (telescopic examination of the pelvis) was performed on this boy. The results are seen on the right. The vas deferens is seen to rise from the pelvis, cross the external iliac vessels and exit through a closed internal inguinal ring. The spermatic vessels, however, course toward the internal inguinal ring, but disappear proximal to the ring.
You can reassure the mother. Most boys with one testis will go through puberty normally and be fertile.
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©David A. Hatch, M.D., 1996