Materiały źródłowe

• #1 Undescended Testicles (Cryptorchidism): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17594-undescended-testicles

  During pregnancy, testicles develop in the abdominal cavity. In most cases, they drop into the scrotum before birth. Undescended testicles dont drop before birth. If the testicles dont descend after six months, your child may need surgery or hormone therapy. […] Undescended testicles are when the testicles fail to drop into the scrotum before birth or in the first few months of life. […] Without treatment, undescended testicles can be serious. They can lower your childs testosterone levels and affect their sperm health. […] If your childs testicles havent dropped by the time theyre 6 months old, talk to a healthcare provider about treatment. If your child needs an orchiopexy, providers recommend they get it between 12 and 24 months of age. […] If testicles dont drop into the scrotum, they may not function properly or produce healthy sperm. They can cause infertility later in life.

• #2 Undescended testicle – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/undescended-testicle/symptoms-causes/syc-20351995

  A testicle that doesn’t move down into its proper place in the scrotum before birth is called an undescended testicle. It’s also known as cryptorchidism (krip-TOR-kih-diz-um). […] An undescended testicle often moves down on its own within a few months after the baby is born. If your baby has an undescended testicle that doesn’t correct itself, surgery can be done to move the testicle into the scrotum. […] Treating an undescended testicle when your child is still a baby might lower the risk of health problems later in life. These include cancer of the testicles and not being able to get a partner pregnant, also called infertility. […] Surgery to correct an undescended testicle might lower the risk of testicular cancer. But the cancer risk doesn’t go away completely. […] Fertility problems might be worse if an undescended testicle goes without treatment for a long time. […] Talk to your child’s doctor or other member of their care team if you notice any changes in your child’s genitals or if you have other concerns.

• #3 Cryptorchidism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470270/

  Cryptorchidism, the most prevalent congenital condition involving male genitalia, is characterized by the absence of at least one testicle from the scrotum; this often manifests unilaterally or bilaterally, with a higher frequency of involvement observed in the right testicle. Approximately 3% of full-term and 30% of premature male infants are born with undescended testicles, necessitating a nuanced understanding among healthcare professionals. […] If the testis has not descended by 6 months, surgical correction through orchiopexy is recommended to minimize risks and potential complications. […] Participants in the course gain a comprehensive understanding of the condition’s diagnosis, management, and long-term implications. […] Furthermore, participants explore the multidisciplinary approach to cryptorchidism management, recognizing the critical role of collaboration among different healthcare professionals.

• #4 Undescended Testis | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/u/undescended-testis

  Undescended testicles (cryptorchidism) refer to a condition in which the testicle does not drop and cannot be brought into the scrotum with external manipulation. This occurs in 3 percent of newborn males and up to 21 percent in premature male newborns. Most testes drop by 3-4 months of age. […] If an undescended testicle is not corrected, the following problems may occur as the male child grows up: […] There are two treatment options: hormonal and surgical. […] In cases in which both sides are undescended, hormonal treatment may aid the testicles descent into the scrotum. The hormone human chorionic gonadotropin (hCG) is given as an injection over several weeks. It cures undescended testes about 10 percent to 15 percent of the time. Surgery may still be needed. […] Your surgeon will give you instructions on how to care for the surgery site. […] Your surgeon will provide after-surgery care for testicular auto-transplant.

• #5 Undescended Testicle | Children’s Hospital Pittsburgh

  https://www.chp.edu/our-services/urology/conditions/undescended-testicle

  An undescended testicle, sometimes called a cryptorchid testicle, is a common problem in young boys. […] There are several reasons that we recommend treatment for persistently undescended testicles. […] Bringing the testicle into the scrotum early might preserve these cells and, therefore, improve chances for fertility in the future. […] A third reason to fix undescended testicles is because of the hernia that is often associated with them. […] Treatment for the undescended testicle depends on the location of the testis. […] This operation is almost always performed as an outpatient. […] It is important to know that not all undescended testes are the same. […] If the testicle cannot be felt by the doctor, it is called an „impalpable” testis (which simply means „cannot be felt”).

• #6 Outbreaks, Alerts and Hot Topics: Undescended Testicles: Steps to Follow Prior to Urology Referral | Children’s Mercy Kansas City

  https://www.childrensmercy.org/health-care-providers/refer-or-manage-a-patient/connect-with-childrens-mercy/newsletter-the-link/link-newsletter-april-2023/outbreaks-alerts-and-hot-topics-undescended-testicles/

  Undescended testicles (cryptorchidism) and retractile testicles are reasonably common findings in the primary care setting. […] American Urological Association (AUA) guidelines suggest that primary care providers should palpate for quality and position of the testes at every well-child visit. […] To ensure that undescended testicles are properly identified, it is important to get a good scrotal exam. […] If the testicle cannot be manipulated into the scrotum or if it quickly returns to the inguinal canal even after an attempt to fatigue the cremasteric muscle, it is likely undescended. This condition will require further evaluation by urology. […] Patients with undescended testicles should be referred as soon as possible and within six months of discovery. […] Any undescended testicles that persist after 6 months of age are unlikely to descend spontaneously and need to be referred to urology. […] Scrotal ultrasounds are not needed prior to a urology referral for undescended testicles.

• #7 Undescended testicles | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/undescended-testicles

  About five per cent of boys are born with undescended testicles. […] Undescended testicles are linked to a range of health problems and conditions, including hernia, testicular cancer and infertility. […] If the testicle is still undescended at three months of age the baby needs to see a paediatric surgeon. […] Undescended testicles should not be confused with retractile or retractable testicles. […] Treatment isnt necessary as long as the retractile testicles stay put inside the scrotum most of the time before the onset of puberty. […] A boy with undescended testicles will have an empty scrotum on one or both sides. The condition is painless, and urination is not affected. […] Premature babies are at increased risk of undescended testicles because the migration of the testicles hasnt had time to occur during development in the womb. Low birth weight babies also have a higher rate of undescended testicles.

• #8 Outbreaks, Alerts and Hot Topics: Undescended Testicles: Steps to Follow Prior to Urology Referral | Children’s Mercy Kansas City

  https://www.childrensmercy.org/health-care-providers/refer-or-manage-a-patient/connect-with-childrens-mercy/newsletter-the-link/link-newsletter-april-2023/outbreaks-alerts-and-hot-topics-undescended-testicles/

  Undescended testicles (cryptorchidism) and retractile testicles are reasonably common findings in the primary care setting. […] American Urological Association (AUA) guidelines suggest that primary care providers should palpate for quality and position of the testes at every well-child visit. […] To ensure that undescended testicles are properly identified, it is important to get a good scrotal exam. […] If the testicle cannot be manipulated into the scrotum or if it quickly returns to the inguinal canal even after an attempt to fatigue the cremasteric muscle, it is likely undescended. This condition will require further evaluation by urology. […] Patients with undescended testicles should be referred as soon as possible and within six months of discovery. […] Any undescended testicles that persist after 6 months of age are unlikely to descend spontaneously and need to be referred to urology. […] Scrotal ultrasounds are not needed prior to a urology referral for undescended testicles.

• #9 Evaluation and Treatment of Cryptorchidism (2018) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/cryptorchidism-guideline

  The purpose of this guideline is to provide physicians and non-physician providers (primary care and specialists) with a consensus of principles and treatment plans for the management of cryptorchidism. […] The panel members are representative of various medical specialties (pediatric urology, pediatric endocrinology, general pediatrics). […] Providers should refer boys with the possibility of newly diagnosed (acquired) cryptorchidism after six months (corrected for gestational age) to an appropriate surgical specialist. (Standard; Evidence Strength: Grade B) […] Providers should not perform ultrasound (US) or other imaging modalities in the evaluation of boys with cryptorchidism prior to referral, as these studies rarely assist in decision making. (Standard; Evidence Strength: Grade B)

• #10 Cryptorchidism (Undescended Testes) Nursing Care Management

  https://nurseslabs.com/cryptorchidism-undescended-testes/

  Cryptorchidism, also known as undescended testes, is a common congenital anomaly in male infants where one or both testicles fail to descend into the scrotum before birth. This nursing notes provides an overview of cryptorchidism, discussing its prevalence, clinical manifestations, diagnostic evaluation, treatment options, and the significance of early detection and timely management to promote normal testicular development and reproductive health in affected individuals. […] Nursing care of a child with cryptorchidism includes the following: […] Assessment of the child involves: […] Physical examination is the most important tool in the diagnostic evaluation of cryptorchidism; the patient must be examined in a warm, relaxed environment; closely observing the scrotum before manipulation is important; the frog-leg or catcher position may be used to facilitate palpation of the testis.

• #11

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Undescended-Testicles.aspx

  Undescended testicles are diagnosed through physical examination. At every well-child visit, the doctor will do a genital examination to check the location of the testicles. […] If your child’s testicle has not come down into the scrotum on its own by 6 months of age, they will likely need treatment. It is relatively rare for undescended testicles to fall into proper position after 6 months of age. So, there is usually little value to waiting. […] Instead, the current approach to treatment involves surgery to relocate the testicle into the scrotum. This surgical procedure is called an orchiopexy. It may need to be performed in a two-stage manner depending on the location of the testicle. […] Since the chances of the testicle coming down on its own is slim after 6 months old, your child should be referred for treatment once they’ve reached that age. Waiting beyond 2-3 years may hinder the testicle’s ability to grow and function normally. Ideally, orchiopexy should be done within the first 18 months of life. […] Pediatricians and pediatric urologists work together to care for boys with undescended testicle. Boys who may need surgery are referred to a pediatric urologist.

• #12 Undescended testicle – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/undescended-testicle/diagnosis-treatment/drc-20352000

  With an undescended testicle, surgery may be needed to find the problem and treat it. There are two main types of surgery: […] Most often, an undescended testicle is fixed with surgery. The surgeon moves the testicle into the scrotum and stitches it into place. This is called orchiopexy (OR-kee-o-pek-see). It can be done through a small cut in the groin, the scrotum or both. […] After surgery, the surgeon monitors the testicle to see that it develops, works right and stays in place. Monitoring might include: Physical exams. Ultrasound exams of the scrotum. Tests of hormone levels. […] Even after surgery, it’s important to check your baby’s testicles to make sure they develop properly. You can check the position of the testicles during diaper changes and baths. […] Your child’s doctor will check the groin. If a testicle isn’t in the scrotum, the provider will try to find it by lightly pressing against the skin. A lubricant or warm, soapy water may be used for the exam.

• #13 Evaluation and Treatment of Cryptorchidism (2018) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/cryptorchidism-guideline

  The purpose of this guideline is to provide physicians and non-physician providers (primary care and specialists) with a consensus of principles and treatment plans for the management of cryptorchidism. […] The panel members are representative of various medical specialties (pediatric urology, pediatric endocrinology, general pediatrics). […] Providers should refer boys with the possibility of newly diagnosed (acquired) cryptorchidism after six months (corrected for gestational age) to an appropriate surgical specialist. (Standard; Evidence Strength: Grade B) […] Providers should not perform ultrasound (US) or other imaging modalities in the evaluation of boys with cryptorchidism prior to referral, as these studies rarely assist in decision making. (Standard; Evidence Strength: Grade B)

• #14 Evaluation and Treatment of Cryptorchidism (2018) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/cryptorchidism-guideline

  Providers should not perform ultrasound (US) or other imaging modalities in the evaluation of boys with cryptorchidism prior to referral, as these studies rarely assist in decision making. (Standard; Evidence Strength: Grade B) […] Providers should assess the possibility of a disorder of sex development (DSD) when there is increasing severity of hypospadias with cryptorchidism. (Recommendation; Evidence Strength: Grade C) […] In boys with bilateral, nonpalpable testes who do not have congenital adrenal hyperplasia (CAH), providers should measure Mllerian Inhibiting Substance (MIS or Anti- Mllerian Hormone [AMH]) level, and consider additional hormone testing, to evaluate for anorchia. (Option; Evidence Strength: Grade C) […] Providers should counsel boys with a history of cryptorchidism and/or monorchidism and their parents regarding potential long-term risks and provide education on infertility and cancer risk. (Clinical Principle)

• #15 Undescended Testicle Causes and Treatment | UPMC

  https://www.upmc.com/services/urology/conditions/undescended-testicle

  Undescended testicles are almost always associated with hernias. […] Treatment for the undescended testicle depends on the location of the testis. […] For testes that can be felt in the groin area, the usual recommendation is an operation called anorchiopexy or orchidopexy. […] This surgery is almost always performed as an outpatient procedure. […] An alternative is hormonal treatment with HCG, a series of injections that stimulate the testicles to make hormones. […] If the testicle cannot be felt by the doctor, it is called an „impalpable” testis. […] Unfortunately, there is no reliable x-ray that can tell us whether a testis is in the abdomen. […] The most accurate operation to locate these testicles is a laparoscopy, a procedure in which a telescope is placed into the abdomen through a small incision near the navel.

• #16 Undescended testicle – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/undescended-testicle/symptoms-causes/syc-20351995

  A testicle that doesn’t move down into its proper place in the scrotum before birth is called an undescended testicle. It’s also known as cryptorchidism (krip-TOR-kih-diz-um). […] An undescended testicle often moves down on its own within a few months after the baby is born. If your baby has an undescended testicle that doesn’t correct itself, surgery can be done to move the testicle into the scrotum. […] Treating an undescended testicle when your child is still a baby might lower the risk of health problems later in life. These include cancer of the testicles and not being able to get a partner pregnant, also called infertility. […] Surgery to correct an undescended testicle might lower the risk of testicular cancer. But the cancer risk doesn’t go away completely. […] Fertility problems might be worse if an undescended testicle goes without treatment for a long time. […] Talk to your child’s doctor or other member of their care team if you notice any changes in your child’s genitals or if you have other concerns.

• #17 Undescended Testicles (Cryptorchidism) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/undescended-testes-cryptorchidism

  Undescended testicles may increase the risk of infertility, especially if both testicles are affected. However, boys who have one undescended testicle tend to father children at the same rate as those who are not affected by the condition at all. […] Surgery is highly recommended in order to reduce the risk of cancer or infertility, to improve your son’s body image through adolescence and adulthood, and to reduce long-term effects and the risk of cancer or infertility. […] If your son’s testicle does not descend on its own before his first birthday, his surgeon will most likely recommend a type of surgery called orchiopexy to move the testicle down into the scrotum. […] Orchiopexy moves the testicles into the scrotum, where they’re about three to five degrees cooler than they would be if they remained inside the abdominal cavity. This improves the chances of fertility later in life.

• #18 Current Management of Undescended Testes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4856300/

  Hormonal therapy is not recommended for treatment of UDTs due to its low success rate, the incidence of secondary re-ascent, and the possible detrimental effects on spermatogenesis. […] Finally, patients with bilateral non-palpable UDTs require a more extensive preliminary evaluation to rule out congenital adrenal hyperplasia (CAH) and disorders of sexual development (DSD). […] The rationale for the treatment of cryptorchidism is to reduce the risk of its long term sequelae, including progressive subfertility/infertility, testicular neoplasms, torsion and cosmetic concerns. […] Spermatogenic function has long been observed to be diminished in the setting of a UDT, which can result in subfertility or infertility. […] Cryptorchidism is one of the few clearly established risk factors for testicular malignancy.

• #19 Undescended Testicle

  https://www.stlukesonline.org/health-services/health-information/healthwise/2015/05/15/14/03/undescended-testicle

  Most of the time, the testicle descends (drops) on its own by the time the baby is 3 months old. If your baby’s testicle hasn’t dropped by the time he is 6 months of age, your doctor may suggest treatment. […] Usually doctors recommend a wait-and-see approach for newborns. If the testicle hasn’t dropped on its own within 6 months, your doctor may recommend surgery (orchiopexy or orchidopexy). Surgery is usually recommended by the time the baby is 18 months old. It is safe and effective and has few risks. Most babies recover quickly. […] Treatment is important because having an undescended testicle increases the risk of: Infertility. Damage to a testicle’s sperm-making ability can begin as early as 12 months of age. That’s why many doctors advise treating an undescended testicle by the time a baby is 1 year old and no later than age 2. Treatment helps lower the chance of infertility. […] Cancer of the testicles. Men who were born with undescended testicles have a higher rate of testicular cancer than other men. But this cancer is rare. It can be cured if found early. If you are a young man who was born with an undescended testicle, talk with your doctor about what you should do.

• #20 Undescended testicle – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/undescended-testicle/symptoms-causes/syc-20351995

  A testicle that doesn’t move down into its proper place in the scrotum before birth is called an undescended testicle. It’s also known as cryptorchidism (krip-TOR-kih-diz-um). […] An undescended testicle often moves down on its own within a few months after the baby is born. If your baby has an undescended testicle that doesn’t correct itself, surgery can be done to move the testicle into the scrotum. […] Treating an undescended testicle when your child is still a baby might lower the risk of health problems later in life. These include cancer of the testicles and not being able to get a partner pregnant, also called infertility. […] Surgery to correct an undescended testicle might lower the risk of testicular cancer. But the cancer risk doesn’t go away completely. […] Fertility problems might be worse if an undescended testicle goes without treatment for a long time. […] Talk to your child’s doctor or other member of their care team if you notice any changes in your child’s genitals or if you have other concerns.

• #21 Undescended testes: What general practitioners need to know

  https://www1.racgp.org.au/ajgp/2019/january%E2%80%93february/undescended-testes

  If a testicular nubbin is found, there is some controversy around mandatory removal because of a potential risk of malignancy. […] Hormonal treatment with gonadotrophin-releasing hormone or human chorionic gonadotropin has been investigated but has not proven efficacious in promoting testicular descent. […] The risk of testicular cancer has been approximated at 2% in UDT; although this is four to five times the risk in the general population, parents can be reassured this is still relatively low. […] UDT is a common disorder that affects 12% of boys and should be referred at three months of age. […] Surgery remains the treatment of choice. […] Decreased fertility is largely a concern for bilateral UDT. Malignancy occurs at a higher rate but remains relatively low risk.

• #22 Undescended Testes | UCSF Department of Urology

  https://urology.ucsf.edu/patient-care/children/genital-anomalies/undescended-testes

  The undescended testicle is the most common birth abnormality involving the male genitals. A testicle that does not occupy a dependent scrotal position at birth is undescended. […] If uncorrected, an undescended testicle can be associated with infertility, inguinal hernia, an increased risk for testicular tumor, psychological difficulties surrounding the appearance of the genitals, or injury due to twisting (torsion) of the testicle. […] The most effective treatment is surgical correction (orchiopexy). The ideal timing for surgery is around 1 year of age. If the testicle has not descended by one year of age, it is unlikely to descend as the child gets older. […] Surgical correction is performed in the outpatient surgery center and your child will be able to go home on the same day of surgery. Your child will typically want to take it easy for the first few days after surgery. Once your child feels up to it they may gradually resume regular activity. This usually occurs within about a week. Your child should wait to resume strenuous activity such as swimming, gymnastics, or ball playing for 2 weeks after surgery.

• #23 Undescended Testicle Causes and Treatment | UPMC

  https://www.upmc.com/services/urology/conditions/undescended-testicle

  Undescended testicles are almost always associated with hernias. […] Treatment for the undescended testicle depends on the location of the testis. […] For testes that can be felt in the groin area, the usual recommendation is an operation called anorchiopexy or orchidopexy. […] This surgery is almost always performed as an outpatient procedure. […] An alternative is hormonal treatment with HCG, a series of injections that stimulate the testicles to make hormones. […] If the testicle cannot be felt by the doctor, it is called an „impalpable” testis. […] Unfortunately, there is no reliable x-ray that can tell us whether a testis is in the abdomen. […] The most accurate operation to locate these testicles is a laparoscopy, a procedure in which a telescope is placed into the abdomen through a small incision near the navel.

• #24 Evaluation and Treatment of Cryptorchidism (2018) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/cryptorchidism-guideline

  In boys with a normal contralateral testis, surgical specialists may perform an orchiectomy (removal of the undescended testis) if a boy has a normal contralateral testis and either very short testicular vessels and vas deferens, dysmorphic or very hypoplastic testis, or postpubertal age. (Clinical Principle) […] Providers should not use hormonal therapy to induce testicular descent as evidence shows low response rates and lack of evidence for long-term efficacy. (Standard; Evidence Strength: Grade B) […] In the absence of spontaneous testicular descent by six months (corrected for gestational age), specialists should perform surgery within the next year. (Standard; Evidence Strength: Grade B) […] In prepubertal boys with palpable, cryptorchid testes, surgical specialists should perform scrotal or inguinal orchidopexy. (Standard; Evidence Strength: Grade B)

• #25

  https://www.nhs.uk/conditions/undescended-testicles/treatment/

  Undescended testicles will usually move down into the scrotum naturally by the time your child is 3 to 6 months old. […] If the testicles don’t descend by 6 months, it’s very unlikely they will without treatment. […] In this case, a surgical procedure called an orchidopexy will be recommended to reposition one or both testicles. […] The operation should ideally be carried out before your child’s 12 months old. […] This is because waiting longer than this may increase a boy’s risk of developing fertility problems (infertility) or testicular cancer later in life. […] Orchidopexies and laparoscopies are performed under a general anaesthetic, which means your child will be asleep during the procedure and won’t feel any pain while it’s carried out. […] The operation normally takes about 1 hour and is usually performed as day surgery, which means your child will be able to return home on the same day.

• #26 Orchiopexy: Purpose, Surgery, Risks & Recovery

  https://my.clevelandclinic.org/health/treatments/17297-orchiopexy

  Orchiopexy is surgery to treat undescended testicles. A surgeon performs it when your baby is between six and 24 months old if their testicles haven’t moved into their scrotum yet. Healthcare providers use orchiopexy to treat undescended testicles and testicular torsion. An orchiopexy is surgery to move undescended testicles or to treat testicular torsion. To treat undescended testicles, a surgeon moves them from inside your child’s belly (abdomen) or groin area and attaches them inside the scrotum (the pouch of skin below your penis). An orchiopexy corrects two conditions: Undescended testicles. This is when a fetus or baby’s testicles don’t drop (descend) from inside their belly into their scrotum before birth or in the first few months of life. If your child’s testicles don’t descend on their own by the time they’re about 6 months old, healthcare providers recommend orchiopexy between 6 and 24 months of age. After orchiopexy, providers will move you or your child to a recovery room. Healthcare providers will monitor you or your child until it’s safe to go home (usually about two hours after the procedure is complete). Your child’s healthcare provider will give you instructions on what to expect, how to manage pain and how to care for the incision site after an orchiopexy. Most children can go back to school or daycare three to five days after an orchiopexy.

• #27 Undescended Testicle | Texas Children’s

  https://www.texaschildrens.org/content/conditions/undescended-testicle

  Cyptrorchidism (also known as undescended testicle) occurs when 1 or both testicles fail to move into the scrotum before birth. […] No intervention is needed for retractile testicles. True undescended testicles diagnosed after 6 months of age need to be corrected with surgery or hormonal injections. […] Palpable testicles will be corrected with a small incision in the groin on the affected side. The testicle is found and released from any attachments; any hernia sac found will be closed. An additional incision is made in the scrotum, the testis is pushed into the scrotum and a stitch anchors it in place. […] Boys with nonpalpable testis generally undergo laparoscopic exploration, which consists of looking into the abdomen with a small camera to identify the testicle if present. Once identified, the testicle will then be placed in the scrotum in one or two stages (orchiopexy).

• #28 Cryptorchidism | Patient Care

  https://weillcornell.org/services/urology/pediatric-urology/conditions-we-treat/cryptorchidism

  Cryptorchidism refers to when a child is born with one or both testicles not present in the scrotum. […] Most pediatric urologists recommend orchiopexy by 1 to 1.5 years of age or earlier. We recommend treatment of the undescended testicle before one year of age. There is evidence that early damage to the germ cells that produce sperm begins at this age. Other reasons to treat are psychological reasons and placement of testicle in position more amenable to physical examination to pick up testis cancer. The most effective treatment is surgery, which can be performed as an outpatient. […] Surgery is immediately performed on ectopic testes, cryptorchids with coexisting hernias and boys at pubertal age. When a testis is felt in the groin area, we usually explore the area through a small incision made in the skin above the scrotum called the inguinal region. Most undescended testes are associated with a hernia that must be repaired. After this is done, the testis is brought down into the scrotum and anchored in a space created in the scrotum (orchiopexy).

• #29 Undescended Testicle | Texas Children’s

  https://www.texaschildrens.org/content/conditions/undescended-testicle

  Cyptrorchidism (also known as undescended testicle) occurs when 1 or both testicles fail to move into the scrotum before birth. […] No intervention is needed for retractile testicles. True undescended testicles diagnosed after 6 months of age need to be corrected with surgery or hormonal injections. […] Palpable testicles will be corrected with a small incision in the groin on the affected side. The testicle is found and released from any attachments; any hernia sac found will be closed. An additional incision is made in the scrotum, the testis is pushed into the scrotum and a stitch anchors it in place. […] Boys with nonpalpable testis generally undergo laparoscopic exploration, which consists of looking into the abdomen with a small camera to identify the testicle if present. Once identified, the testicle will then be placed in the scrotum in one or two stages (orchiopexy).

• #30 Surgery for Undescended Testicles | NYU Langone Health

  https://nyulangone.org/conditions/undescended-testicles-in-children/treatments/surgery-for-undescended-testicles

  Many infants with undescended testicles, which is also referred to as cryptorchidism, do not need treatment, because the testicles move to the scrotum within the first few months of life. But if a boys testicles have not descended by age 6 to 12 months, NYU Langone pediatric urologists recommend surgery to move them into the scrotum. […] If a boys undescended testicles are palpable, or able to be felt by a doctor, a pediatric urologic surgeon may perform a surgical procedure called an orchiopexy to reposition them. An orchiopexy is an outpatient procedure that takes place in the hospital and requires general anesthesia. Pediatric urologic surgeons at NYU Langone are experienced in performing this surgery in boys as young as 6 months old. […] Most boys only need one surgery to correct this condition. Sometimes, if the testicles are located high in the abdomen, the blood vessels attached to them may not be long enough to allow the testicles to be placed in the scrotum. Two surgeries performed several months apart may be necessary to safely position the testicles in the scrotum.

• #31

  https://www.nhs.uk/conditions/undescended-testicles/treatment/

  Undescended testicles will usually move down into the scrotum naturally by the time your child is 3 to 6 months old. […] If the testicles don’t descend by 6 months, it’s very unlikely they will without treatment. […] In this case, a surgical procedure called an orchidopexy will be recommended to reposition one or both testicles. […] The operation should ideally be carried out before your child’s 12 months old. […] This is because waiting longer than this may increase a boy’s risk of developing fertility problems (infertility) or testicular cancer later in life. […] Orchidopexies and laparoscopies are performed under a general anaesthetic, which means your child will be asleep during the procedure and won’t feel any pain while it’s carried out. […] The operation normally takes about 1 hour and is usually performed as day surgery, which means your child will be able to return home on the same day.

• #32 Undescended Testes | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/undescended-testes

  If a testicle has not reached the scrotum by the time the baby is 6 months of age, it is considered an undescended testicle. This can occur to one or both testicles. […] If the testicle is not felt in the scrotum by 6 months of age, or if the testis is very high at 3 months of age, our team in the Division of Urology will recommend surgery. The surgical procedure to bring the testicle down into the scrotum is called an orchiopexy (also known as orchidopexy). […] We perform these surgeries in the operating room. Generally a small incision is made in the groin and in the scrotum. The testicle is pulled down and placed in a small pouch in the scrotum and attached with stitches. Your child should be able to go home the same day. […] Each year, our physicians perform nearly 600 orchiopexies. It is one of the more common surgeries we do in our Division.

• #33 Evaluation and Treatment of Cryptorchidism (2018) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/cryptorchidism-guideline

  In boys with a normal contralateral testis, surgical specialists may perform an orchiectomy (removal of the undescended testis) if a boy has a normal contralateral testis and either very short testicular vessels and vas deferens, dysmorphic or very hypoplastic testis, or postpubertal age. (Clinical Principle) […] Providers should not use hormonal therapy to induce testicular descent as evidence shows low response rates and lack of evidence for long-term efficacy. (Standard; Evidence Strength: Grade B) […] In the absence of spontaneous testicular descent by six months (corrected for gestational age), specialists should perform surgery within the next year. (Standard; Evidence Strength: Grade B) […] In prepubertal boys with palpable, cryptorchid testes, surgical specialists should perform scrotal or inguinal orchidopexy. (Standard; Evidence Strength: Grade B)

• #34 Current Management of Undescended Testes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4856300/

  Hormonal therapy is not recommended for treatment of UDTs due to its low success rate, the incidence of secondary re-ascent, and the possible detrimental effects on spermatogenesis. […] Finally, patients with bilateral non-palpable UDTs require a more extensive preliminary evaluation to rule out congenital adrenal hyperplasia (CAH) and disorders of sexual development (DSD). […] The rationale for the treatment of cryptorchidism is to reduce the risk of its long term sequelae, including progressive subfertility/infertility, testicular neoplasms, torsion and cosmetic concerns. […] Spermatogenic function has long been observed to be diminished in the setting of a UDT, which can result in subfertility or infertility. […] Cryptorchidism is one of the few clearly established risk factors for testicular malignancy.

• #35 Nursing Care Plan For Undescended Testes – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-undescended-testes/

  Undescended testes, also known as cryptorchidism, is a congenital condition characterized by the failure of one or both testicles to descend into the scrotum. A nursing care plan for undescended testes is essential to address the unique challenges associated with this condition, emphasizing early detection, timely intervention, and comprehensive support. This care plan aims to provide a structured framework for healthcare professionals to deliver evidence-based care, promote informed decision-making, and optimize outcomes for individuals affected by undescended testes. […] By integrating assessments, interventions, and education, the care plan strives to address both the physical and psychosocial aspects of undescended testes. The focus is on promoting proper testicular descent, preventing complications, and supporting the individual and their family throughout the diagnostic and treatment process.

• #36 Cryptorchidism (Undescended Testes) Nursing Care Management

  https://nurseslabs.com/cryptorchidism-undescended-testes/

  Based on the assessment data, the major nursing diagnoses are: […] Deficient knowledge related to the condition and surgery. […] The major goals for the patient are: […] The family caregivers will be able to verbalize an understanding of the condition and the surgical intervention. […] The nursing interventions appropriate for the patient are: […] Determine the child’s expectations regarding illness and hospitalization through discussion and play therapy; explain the anatomy and physiology of the urinary system in terms the child can understand; use a body outline appropriate for the age of the child, and explain all diagnostic tests before their occurrence. […] Administer antibiotics and I.V. fluids as ordered; maintain patency of catheters; provide catheter care as directed; administer wound care using aseptic technique, and inspect incision for drainage or signs of infection. […] Goals are met as evidenced by: […] The family caregivers verbalized understanding of the condition and the surgical intervention. […] Documentation in a patient with cryptorchidism includes: […] Responses to interventions, teaching, and actions performed.

• #37 Undescended Testicle (Orchiopexy) Repair Surgery

  https://www.chp.edu/our-services/surgery-pediatric/patient-procedures/undescended-testicle-orchiopexy-repair-surgery

  The most important role of a parent or guardian is to help your child stay calm and relaxed before the surgery. The best way to help your child stay calm is for you to stay calm. […] After your child is discharged and goes home, he might still be groggy and should take it easy for the day. […] Your child should take Tylenol or Motrin 4 hours after the surgery, which will help with discomfort when the anesthesia wears off. Pain medication is rarely needed after 2 days. […] After the operation, activity needs to be somewhat restricted.

• #38

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zy1328

  After surgery, your child may feel tired. Your child will need to recover in a crib or bed for a few days. Let your child return to normal activities when your child seems ready or when your doctor says it is okay. This is usually in 2 or 3 days. […] Your child may also have pain, swelling, or bruises in the groin area. Medicines can help with pain. Swelling or bruising should start to go away 2 to 3 weeks after surgery. […] Let your child rest in bed for a few days. Sleeping will help him recover. […] Have your baby or toddler avoid doing any tumbling for a few days. Have your child avoid doing straddling activities, such as riding a tricycle or using a sit-on toy, for 3 to 4 weeks. […] Do not let your child do intense exercise, such as sports, running, or physical education at school, for 4 to 6 weeks.

• #39 Undescended Testicle Surgery (Orchiopexy) | Children’s Hospital of Philadelphia

  https://www.chop.edu/treatments/surgery-undescended-testicles-orchiopexy

  An undescended testicle needs to be treated surgically with a procedure called orchiopexy before your child is 2 years old to increase his chance for fertility later in life. […] Here’s what you need to know after your son has undergone an orchiopexy: […] Pain control: before surgery, your son will receive a local anesthesia along with the general anesthesia. This medicine will keep your child pain-free for four to six hours. After your son goes home, he may need acetaminophen (TYLENOL) to relieve the pain. […] Follow-up: please bring your son in for a follow-up appointment two weeks after surgery. […] Be sure to call your child’s surgeon’s office if: Your child has any signs of infections: Redness or drainage along the incision site, Fever greater than 101 degrees.

• #40

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zy1328

  Your child may shower or have a sponge bath the day after surgery. Do not let him swim or have a bath for 5 to 7 days. […] Your child should be able to go back to school or daycare in 2 or 3 days. […] Have your child drink plenty of fluids for the first 24 hours to avoid becoming dehydrated. […] When your child is ready to eat, start with foods that are easy to swallow. […] Avoid giving your child steamy, hot, spicy, or hard and crunchy foods, such as chips or waffles. […] If your child has strips of tape on the incision, leave the tape on for a week or until it falls off. […] Wash the area daily with warm, soapy water and pat it dry. Don’t use hydrogen peroxide or alcohol, which can slow healing. […] Keep the area clean and dry. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems. […] Call your doctor or nurse advice line now or seek immediate medical care if: Your child has pain that does not get better after he takes pain medicine. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if your child has any problems.

• #41 Orchiopexy for Undescended Testicle (Inpatient Care)

  https://www.drugs.com/cg/orchiopexy-for-undescended-testicle-inpatient-care.html

  Orchiopexy is surgery to move one or both of your child’s undescended testicles from his lower abdomen into his scrotum. […] Your child may be taken to a recovery room until he is fully awake. Healthcare providers will watch him closely for any problems. When healthcare providers see that your child is okay, he will leave the recovery room. Depending on his condition and type of surgery, he may be taken to his hospital room or allowed to go home. The bandages that cover his stitches will keep the area clean and dry to prevent infection. A healthcare provider may remove the bandages soon after your child’s surgery to check his abdominal area. […] Let your child rest and sleep as much as he wants. Ice may be applied to your child’s surgery area to decrease pain and swelling. Your child’s scrotum may swell and be painful for several days after surgery. He may be bruised at the surgery site or in his scrotum.

• #42 Undescended Testicle | Texas Children’s

  https://www.texaschildrens.org/content/conditions/undescended-testicle

  After surgery, your son will usually be discharged home the same day. His doctor will prescribe pain medicine for his discomfort, but children’s acetaminophen or ibuprofen is also helpful. He should not take a full bath for 3 days. He should also avoid straddling toys such as bicycles, walkers and bounce toys, and strenuous activities for 2-3 weeks following the surgery. […] Regular testicular self-exam is important after reaching puberty for these adolescents and men as it is for all men.

• #43

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zy1328

  After surgery, your child may feel tired. Your child will need to recover in a crib or bed for a few days. Let your child return to normal activities when your child seems ready or when your doctor says it is okay. This is usually in 2 or 3 days. […] Your child may also have pain, swelling, or bruises in the groin area. Medicines can help with pain. Swelling or bruising should start to go away 2 to 3 weeks after surgery. […] Let your child rest in bed for a few days. Sleeping will help him recover. […] Have your baby or toddler avoid doing any tumbling for a few days. Have your child avoid doing straddling activities, such as riding a tricycle or using a sit-on toy, for 3 to 4 weeks. […] Do not let your child do intense exercise, such as sports, running, or physical education at school, for 4 to 6 weeks.

• #44

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zy1328

  Your child may shower or have a sponge bath the day after surgery. Do not let him swim or have a bath for 5 to 7 days. […] Your child should be able to go back to school or daycare in 2 or 3 days. […] Have your child drink plenty of fluids for the first 24 hours to avoid becoming dehydrated. […] When your child is ready to eat, start with foods that are easy to swallow. […] Avoid giving your child steamy, hot, spicy, or hard and crunchy foods, such as chips or waffles. […] If your child has strips of tape on the incision, leave the tape on for a week or until it falls off. […] Wash the area daily with warm, soapy water and pat it dry. Don’t use hydrogen peroxide or alcohol, which can slow healing. […] Keep the area clean and dry. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems. […] Call your doctor or nurse advice line now or seek immediate medical care if: Your child has pain that does not get better after he takes pain medicine. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if your child has any problems.

• #45

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zy1328

  Your child may shower or have a sponge bath the day after surgery. Do not let him swim or have a bath for 5 to 7 days. […] Your child should be able to go back to school or daycare in 2 or 3 days. […] Have your child drink plenty of fluids for the first 24 hours to avoid becoming dehydrated. […] When your child is ready to eat, start with foods that are easy to swallow. […] Avoid giving your child steamy, hot, spicy, or hard and crunchy foods, such as chips or waffles. […] If your child has strips of tape on the incision, leave the tape on for a week or until it falls off. […] Wash the area daily with warm, soapy water and pat it dry. Don’t use hydrogen peroxide or alcohol, which can slow healing. […] Keep the area clean and dry. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems. […] Call your doctor or nurse advice line now or seek immediate medical care if: Your child has pain that does not get better after he takes pain medicine. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if your child has any problems.

• #46 2 Cryptorchidism (Undescended Testes) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cryptorchidism-undescended-testes-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with cryptorchidism may include: Assess origin and anxiety level and how it is expressed; need for information that will alleviate anxiety. […] The risk of infection for a child with cryptorchidism is increased due to inadequate primary defenses, such as broken or irritated skin in the area surrounding the undescended testes. […] Educate caregivers on skin and wound assessment and watch out for signs and symptoms of infection, complications, and healing. Early assessment prompts immediate intervention thus preventing the occurrence of complications.

• #47 Orchiopexy for Undescended Testicle (Inpatient Care)

  https://www.drugs.com/cg/orchiopexy-for-undescended-testicle-inpatient-care.html

  Your child may bleed more than usual during surgery or get an infection later. His testicle may move back up again later and he may need another surgery. Blood vessels that carry blood to the testicle may be cut or damaged during surgery. This can cause your child’s testicle to shrink. This could affect his ability to father children later in life. […] You have the right to help plan your child’s care. Learn about your child’s health condition and how it may be treated. Discuss treatment options with your child’s healthcare providers to decide what care you want for your child.

• #48 Surgery for Undescended Testicles | NYU Langone Health

  https://nyulangone.org/conditions/undescended-testicles-in-children/treatments/surgery-for-undescended-testicles

  Most children can return home the day of surgery. The doctor may prescribe a mild pain reliever, such as acetaminophen. […] To promote healing and prevent discomfort, NYU Langone doctors recommend that your baby avoid straddle toys or bouncy seats in the days following surgery. However, its important that infants and children continue to be buckled in their safety seats to avoid injury during travel. […] NYU Langone doctors typically recommend a follow-up visit 10 to 14 days after surgery. During this appointment, they determine if your child is feeling better and healing well. The stitches used to close the incision are dissolvable. […] Another follow-up visit is usually scheduled for about four months after surgery. This allows the doctor to reexamine your child.

• #49 Cryptorchidism | Patient Care

  https://weillcornell.org/services/urology/pediatric-urology/conditions-we-treat/cryptorchidism

  Long-term issues include infertility and tumorigenesis. After the initial post-operative visits, children should be seen 1 year after surgery to note the location and size of the testes. At puberty, boys should be taught how to perform monthly testicular self-examinations. The threshold for future ultrasound examinations is based on the type of tumor and physical exams. Once the boys reach adulthood, issues regarding fertility must be further explored with a urologist.

• #50

  https://www.nhs.uk/conditions/undescended-testicles/treatment/

  Possible side effects and complications of an orchidopexy include: bleeding, swelling or bruising where the incisions were made; the wound becoming infected; the testicle moving up into the groin again; the blood supply not being able to sustain the testicle in its new position, which causes it to wither away (testicular atrophy); damage to the tube connecting the testicle to the urethra (vas deferens), which can make it difficult for semen to pass through. […] In general, complication rates are low. The main risk is loss (atrophy) of the testicle.

• #51

  https://www.nhs.uk/conditions/undescended-testicles/treatment/

  Possible side effects and complications of an orchidopexy include: bleeding, swelling or bruising where the incisions were made; the wound becoming infected; the testicle moving up into the groin again; the blood supply not being able to sustain the testicle in its new position, which causes it to wither away (testicular atrophy); damage to the tube connecting the testicle to the urethra (vas deferens), which can make it difficult for semen to pass through. […] In general, complication rates are low. The main risk is loss (atrophy) of the testicle.

• #52 Cryptorchidism – Wikipedia

  https://en.wikipedia.org/wiki/Cryptorchidism

  In cases where the testes are identified preoperatively in the inguinal canal, orchiopexy is often performed as an outpatient and has a very low complication rate. […] The principal major complication of all types of orchiopexy is a loss of the blood supply to the testis, resulting in loss of the testis due to ischemic atrophy or fibrosis.

• #53 Undescended Testicles (Cryptorchidism): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17594-undescended-testicles

  Surgery to fix undescended testicles has a high success rate about 98% effective. In most cases, the testicles develop normally in the scrotum and produce healthy sperm later in life. […] You may experience a lot of emotions if your child needs surgery to fix undescended testicles. But learning about the procedure and asking your childs healthcare provider questions can help you remain calm, which can help your child relax.

• #54 Recovery & Support for Undescended Testicles | NYU Langone Health

  https://nyulangone.org/conditions/undescended-testicles-in-children/support

  NYU Langone pediatric urologists offer guidance to the families of boys who have had surgery to correct undescended testicles. […] The success rate for surgery to correct undescended testicles is greater than 96 percent. Treatment before age 2 is recommended to help lower a boys risk of developing changes in the testicle that can possibly result in infertility. […] Although surgery may reduce the risk of testicular cancer, it does not eliminate it. Our doctors recommend that boys learn how to perform a monthly testicular self-examination starting at puberty. […] Our doctors understand that you may have concerns about your childs reproductive health in the future. […] Boys who have had surgery to correct two undescended testicles may experience infertility in adulthood, depending on the location of the testicles prior to surgery.

• #55 Undescended Testicles (Cryptorchidism) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/undescended-testes-cryptorchidism

  Undescended testicles may increase the risk of infertility, especially if both testicles are affected. However, boys who have one undescended testicle tend to father children at the same rate as those who are not affected by the condition at all. […] Surgery is highly recommended in order to reduce the risk of cancer or infertility, to improve your son’s body image through adolescence and adulthood, and to reduce long-term effects and the risk of cancer or infertility. […] If your son’s testicle does not descend on its own before his first birthday, his surgeon will most likely recommend a type of surgery called orchiopexy to move the testicle down into the scrotum. […] Orchiopexy moves the testicles into the scrotum, where they’re about three to five degrees cooler than they would be if they remained inside the abdominal cavity. This improves the chances of fertility later in life.

• #56 Undescended testicles | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/undescended-testicles

  Surgery is the best treatment for undescended testicles. […] Ideally, the child should be aged between six months and one year at the time of surgery. […] Research suggests that future sperm quality in the affected testicle is compromised if the condition is corrected after the child is two years old. […] About 10 per cent of males who undergo surgical correction experience reduced fertility later in life. […] Surgery to relocate the testicles inside the scrotum is called orchidopexy. […] In about five per cent of cases of undescended testicles, surgeons cant find the missing testicle. […] Your childs GP should check him for acquired undescended testicles around the time that he starts school. […] If you think that your childs testes may have moved back into his groin, see a GP.

• #57 Undescended testicle Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/undescended-testicle

  Undescended testicle occurs when one or both testicles fail to move into the scrotum before birth. […] An undescended testicle is more likely to develop cancer, even if it is brought into the scrotum with surgery. […] Bringing the testicle into the scrotum can improve sperm production and increase the chances of good fertility. It also allows the provider to do an exam for the early detection of cancer. […] In most cases, the testicle will descend without treatment during the child’s first year. If this does not occur, treatment may include: Hormone injections (B-HCG or testosterone) to try to bring the testicle into the scrotum. Surgery (orchiopexy) to bring the testicle into the scrotum. This is the main treatment. […] Having surgery early may prevent damage to the testicles and avoid infertility. An undescended testicle that is found later in life may need to be removed. This is because the testicle is not likely to function well and could pose a risk for cancer. […] Contact your child’s provider if he appears to have an undescended testicle.

• #58 Undescended Testes | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/undescended-testes

  If a testicle has not reached the scrotum by the time the baby is 6 months of age, it is considered an undescended testicle. This can occur to one or both testicles. […] If the testicle is not felt in the scrotum by 6 months of age, or if the testis is very high at 3 months of age, our team in the Division of Urology will recommend surgery. The surgical procedure to bring the testicle down into the scrotum is called an orchiopexy (also known as orchidopexy). […] We perform these surgeries in the operating room. Generally a small incision is made in the groin and in the scrotum. The testicle is pulled down and placed in a small pouch in the scrotum and attached with stitches. Your child should be able to go home the same day. […] Each year, our physicians perform nearly 600 orchiopexies. It is one of the more common surgeries we do in our Division.

• #59 Evaluation and Treatment of Cryptorchidism (2018) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/cryptorchidism-guideline

  Cryptorchidism or undescended testis (UDT) is one of the most common pediatric disorders of the male endocrine glands and the most common genital disorder identified at birth. The main reasons for treatment of cryptorchidism include increased risks of impairment of fertility potential, testicular malignancy, torsion and/or associated inguinal hernia. The current standard of therapy in the United States is orchidopexy (also referred to as orchiopexy in the literature), or surgical repositioning of the testis within the scrotal sac, while hormonal therapy has fewer advocates. Successful scrotal relocation of the testis, however, may reduce but does not prevent these potential long-term sequelae in susceptible individuals. The purpose of this guideline is to provide physicians and non-physician providers (primary care and specialists) with a consensus of principles and treatment plans for the management of cryptorchidism.

• #60 Evaluation and Treatment of Cryptorchidism (2018) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/cryptorchidism-guideline

  Providers should obtain gestational history at initial evaluation of boys with suspected cryptorchidism. (Standard; Evidence Strength: Grade B) […] Providers should refer infants with a history of cryptorchidism (detected at birth) who do not have spontaneous testicular descent by six months (corrected for gestational age) to an appropriate surgical specialist for timely evaluation. (Standard; Evidence Strength: Grade B) […] Providers should not use hormonal therapy to induce testicular descent as evidence shows low response rates and lack of evidence for long-term efficacy. (Standard; Evidence Strength: Grade B) […] In the absence of spontaneous testicular descent by six months (corrected for gestational age), specialists should perform surgery within the next year. (Standard; Evidence Strength: Grade B)

• #61 Evaluation and Treatment of Cryptorchidism (2018) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/cryptorchidism-guideline

  In prepubertal boys with palpable, cryptorchid testes, surgical specialists should perform scrotal or inguinal orchidopexy. (Standard; Evidence Strength: Grade B) […] In prepubertal boys with nonpalpable testes, surgical specialists should perform examination under anesthesia to reassess for palpability of testes. If nonpalpable, surgical exploration and, if indicated, abdominal orchidopexy should be performed. (Standard; Evidence Strength: Grade B) […] Providers should counsel boys with a history of cryptorchidism and/or monorchidism and their parents regarding potential long-term risks and provide education on infertility and cancer risk. (Clinical Principle) […] Providers must immediately consult an appropriate specialist for all phenotypic male newborns with bilateral, nonpalpable testes for evaluation of a possible disorder of sex development (DSD). (Standard; Evidence Strength: Grade A)

• #62 Assessment and Management of Undescended Testis – PAEDIATRIC INNOVATION, EDUCATION & RESEARCH NETWORK

  https://www.piernetwork.org/undescended-testes-unused.html

  Assessment and Management of Undescended Testes […] Orchidopexy for undescended testis (UDT) is one of the most common paediatric surgical operations. Each year there are around 6,000 elective orchidopexies performed in England for undescended testes. […] Patients and their families benefit from assessment and surgery performed locally, with selected referral to a tertiary paediatric surgical centre, governed by clinical need. […] The purpose of this guideline is to describe a standardised approach to the diagnosis, assessment and management of Undescended Testis. […] All male infants should be assessed for testicular mal-descent at both the neonatal baby check and the 6-8 week postnatal examination. […] If the testis remains undescended/impalpable they should all be referred by 4 months of age on an outpatient basis to an appropriate Secondary Care Surgical Provider with appropriate experience and skills to manage the patient at their local hospital.

• #63 Undescended testicles: Why prompt referral is key

  https://answers.childrenshospital.org/undescended-testicles/

  As tempting as it may be to send the patient for an ultrasound prior to referring them to a urologist, Dr. Nelson urges prompt referral to a specialist instead. […] That’s important because the longer the wait before surgery, the higher the risk of complications the child may experience down the road. Potential complications include fertility issues, hormonal problems, and testicular cancer. Current practice is to surgically correct undescended testicles by 18 months of age. […] For Dr. Nelson, the most important take-home message to pediatricians who suspect undescended testicles for any infant or child is to immediately refer them to a urologist without hesitation.

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