A treatment of undescended testicle in infancy.

This study is based upon the examination of 2,700 newborn boys. The original purpose was to find out how often the testicle was undescended at birth and what happened in such cases during the first few months of life. It is not difficult to feel the testicle of a newborn boy if it be lying outside the external inguinal ring. Examination may only become uncertain, and at times impossible, when the natural increase of subcutaneous fat and the activity of the cremaster muscle combine to conceal the organ in the groin. These events, however, do not occur until the age of 6 months or more and even then are usually insufficient to cast doubt on the findings. Because the testicle can be felt in the scrotum at birth it is possible to measure its distance from the pubic crest with reasonable accuracy. By so measuring, a standard can be established by which to judge whether descent has, or has not, taken place. The suggested figure in this investigation is 4 cm. (1 in.): at this point the testicle can lie comfortably in the scrotum. This standard represents a minimum distance in a full-term infant (5 lb. 8 oz. or more) and it continues to be valuable for many years. It is normally found that in both infants and boys up to puberty the testicle lies between 4 cm. and 8 cm. from the pubic crest, depending largely on the degree of scrotal contraction. In adolescence, owing to increase in size of both testicle and scrotum, the normal distance is greater.