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Causes
By Mayo Clinic staffAn overactive muscle causes a testicle to become a retractile testicle. The cremaster muscle is a thin pouch-like muscle in which a testicle rests. When the cremaster muscle contracts, it pulls the testicle up toward the body.
The primary purpose of the muscle is to control the temperature of the testicle. In order for a testicle to develop and function properly, it needs to be slightly cooler than normal body temperature. When the environment is warm, the cremaster muscle is relaxed; when the environment is cold, the muscle contracts and draws the testicle toward the warmth of the body.
During childhood, the cremaster muscle may be particularly overactive. If this reflex is strong enough, it can result in a retractile testicle, pulling the testicle out of the scrotum and up into the groin.
Causes of an ascending testicle
About one-third of retractile testicles become ascending testicles. This means a once-moveable testicle can no longer be easily guided into position in the scrotum. Instead of being capable of moving up and down (retractile), the testicle is stuck in the "up position" (ascending).
A normal testicle residing in the scrotum — one that was never retractile — also can become an ascending testicle, or move permanently into the "up position."
The ascending testicle occurs because some part of the anatomy is pulling up on the testicle. Contributing factors may be:
- Short spermatic cord. Each testicle is attached to the end of the spermatic cord, which extends down from the groin and into the scrotum. The cord houses blood vessels, nerves and the tube that carries semen from the testicle to the penis. If growth of the spermatic cord doesn't keep pace with other body growth, the "shortened," or "tight," cord may pull the testicle up.
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Problem with the normal path of a descending testicle. Before a testicle descends during fetal development, a tiny bag-like extension of the abdominal lining creates a path for the testicle to follow into the scrotum. Normally the thin upper portion of this bag closes off, and any remnants of the upper portion disintegrate. Sometimes this structure fails to close off and detach from the abdomen, resulting in an upward pull on the testicle.
In other cases, the top portion will close off, but a remnant of the structure remains and limits the growth or elasticity of the spermatic cord. Consequently, the spermatic cord pulls upward on the testicle.
- Scar tissue from hernia surgery. Incomplete closure of the bag-like extension from the abdomen may result in a small gap in the abdominal lining through which a portion of the intestines can push itself into the groin. This condition is called an inguinal hernia. Scar tissue following surgery to repair the hernia may limit the growth or elasticity of the spermatic cord.
- Other injuries. Scar tissue from a testicular infection or a traumatic injury also may limit the growth or elasticity of the spermatic cord.
