Materiały źródłowe

• #1 Cryptorchidism – Wikipedia

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

  Cryptorchidism, also known as undescended testis, is the failure of one or both testes to descend into the scrotum. About 3% of full-term and 30% of premature infant boys are born with at least one undescended testis. However, about 80% of cryptorchid testes descend by the first year of life, making the true incidence of cryptorchidism around 1% overall. The most common diagnostic dilemma in otherwise normal boys is distinguishing a retractile testis from a testis that will not descend spontaneously into the scrotum. In the minority of cases with bilaterally nonpalpable testes, further testing to locate the testes, assess their function, and exclude additional problems is often useful. Scrotal ultrasound or magnetic resonance imaging performed and interpreted by a radiologist can often locate the testes while confirming absence of a uterus. A karyotype can confirm or exclude forms of dysgenetic primary hypogonadism, such as Klinefelter syndrome or mixed gonadal dysgenesis. Hormone levels (especially gonadotropins and AMH) can help confirm that hormonally functional testes are worth attempting to rescue.

• #1 Diagnosing Undescended Testicles | NYU Langone Health

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

  NYU Langone pediatric urologists doctors who specialize in managing congenital urinary tract problems offer expert diagnosis of undescended testicles. […] Doctors usually diagnose undescended testicles during a physical exam performed immediately after birth or shortly thereafter. […] Your child’s doctor may order a pelvic ultrasound to determine the exact location of an undescended testicle if it is not easily felt or palpable.

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

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

  Not seeing or feeling a testicle in the scrotum is the main symptom of an undescended testicle. […] An undescended testicle often is found during an exam done shortly after birth. If your baby has an undescended testicle, ask how often exams will need to be done. If the testicle hasn’t moved into the scrotum by 3 to 4 months of age, the condition likely won’t correct itself. […] Treating an undescended testicle when your child is still a baby might lower the risk of health problems later in life. […] The exact cause of an undescended testicle isn’t known. […] The testicles need to be slightly cooler than regular body temperature to develop and work well. […] Men who’ve had an undescended testicle have a higher risk of testicular cancer. […] Surgery to correct an undescended testicle might lower the risk of testicular cancer. […] Fertility problems make it harder to get a partner pregnant. They’re more likely to happen in men who’ve had an undescended testicle.

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

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

  Undescended testis (UDT) is a common condition, and parents often primarily present to general practitioners. […] The aim of this article is to summarise the key points of assessment and management of UDT in the primary care setting. […] Current evidence does not support the use of ultrasonography prior to referral. […] Ideally, the physical examination should be done in a warm environment and when the child is calm. […] A significant suprapubic fat pad can influence the examination and make a UDT difficult to detect. […] Classify the testis as normal, high scrotal, supra-scrotal or impalpable. […] Ultrasonography is not helpful prior to referral. […] Current guidelines recommend referral at 36 months for unilateral UDT, and orchidopexy between six and 12 months. […] Examination under anaesthesia and diagnostic laparoscopy is the treatment for impalpable testes.

• #1 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. It occurs in approximately: 10% of premature infants, 3% of full-term infants, 0.8% of boys at 6 months of age, 0.8% of boys during puberty. […] Diagnosis is made solely by physical exam. The doctor will observe the shape and appearance of the scrotum, then feel or press with his hands to determine whether the testcle is palpable or nonpalpable and where it is located. […] Scrotal ultrasound or other imaging is not necessary or recommended due to frequent false-positive or false-negative results. In more complicated situations the pediatric urologist may rarely suggest a scrotal ultrasound.

• #1 Undescended Testes (Maldescended and Retractile Testes)

  https://patient.info/doctor/undescended-and-maldescended-testes

  An undescended testis is a testis that is absent from the scrotum. […] This is by physical examination. […] Around 70% of all undescended testes are palpable. […] It can be difficult to distinguish undescended testes from retractile testes. […] Imaging or ultrasound does not add any benefit to differentiating between palpable and non-palpable testes. […] Diagnostic laparoscopy is usually the preferred method to confirm or rule out an intra-abdominal, inguinal or absent/vanishing testis (non-palpable testis). […] The EAU’s Paediatric Urology guidelines suggest that undescended and maldescended testes should be categorised into palpable and non-palpable testes, as the location and existence of the testis affects clinical management. […] If, by the age of 6 months, descent has not occurred, spontaneous descent is unlikely. Treatment should be completed by 18 months at the latest as there is potential for histological deterioration and loss of testicular quality after that time which may affect future fertility.

• #1 Cryptorchidism: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438378-overview

  Birth weight is the principal determining factor for undescended testes at birth to age 1 year, independent of the length of gestation. […] In cryptorchidism, the most useful determination is whether the testes are palpable upon physical examination. […] Approximately 80% of undescended testes are palpable and 20% are nonpalpable. […] Indications for hormonal or surgical correction of cryptorchidism are described below. […] Early reposition of the testis into the scrotum has been a mainstay of treatment to reduce the risk of infertility; however, even with successful orchidopexy at age 6-12 months, 20-25% of boys with nonsyndromic cryptorchidism have compromised fertility potential. […] Males with undescended testis are 40 times as likely to develop testicular cancer as males without undescended testis. […] Prepubertal orchiopexy reduces this risk. […] The location of the undescended testis affects the relative risk of testicular cancer. Up to 50% of malignant testicular tumors associated with cryptorchidism involve intra-abdominal testes.

• #1 Cryptorchidism – Pathophysiology – Managment – TeachMePaediatrics

  https://teachmepaediatrics.com/surgery/urology/cryptorchidism/

  Cryptorchidism is a congenital absence of one or both testes in the scrotum due to a failure of the testes to descend during development. […] Cryptorchidism, or the failure of testicular descent into the scrotum, is a surgical condition found in 6% of newborns, but drops to 1.5-3.5% of males at 3 months. […] One of the key elements in the history is to clarify if the testis has ever been seen or palpated within the scrotum, such as in the newborn check. […] Initial inspection may reveal testis within the scrotum, therefore a diagnosis of retractile or normal descended testis can be made. […] Around 80% of undescended testis are palpable, therefore should be found with a good examination. […] If found, one should attempt to see if the testis can be gently milked down to the base of the scrotum, in which case a diagnosis of retractile testis can be made, if it is pulled down but under tension in the base, this commonly referred to as a high scrotal or simply high testis.

• #1 Diagnostic Imaging in Cryptorchidism: Utility, Indications, and Effectiveness

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3712862/

  Cryptorchidism (undescended testis) is the most common genitourinary anomaly in male infants. […] We reviewed the available literature on the diagnostic performance of ultrasound, CT, and MRI in localizing undescended testes. […] Ultrasound is the most heavily utilized imaging modality to evaluate undescended testes. […] Given the poor ability to localize non-palpable testes, ultrasound has no role in the routine evaluation of boys with cryptorchidism. […] Diagnostic imaging has been utilized to determine the anatomic location of non-palpable testes. […] Current US Department of Health and Human Services guidelines state that ultrasound, CT, or MRI do not provide additional information to the physical examination. […] We review the utility of ultrasound, CT, and MRI in the evaluation of boys with undescended testes and also address clinical scenarios in which the presence of associated abnormalities merits the use of diagnostic imaging.

• #1 Cryptorchidism – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/741

  Cryptorchidism diagnosis is made on physical exam when one or both testes are not present within the dependent portion of the scrotal sac. […] Approximately 70% of cryptorchid testes are palpable within the upper portion of the scrotum or inguinal canal, whereas the other 30% are not palpable, suggesting either an intra-abdominal location, testicular nubbin, or anorchia. […] Referral to a specialist should be made by 6 months corrected gestational age and surgical correction should be performed within the next year. Testes that remain undescended by 6 months are unlikely to descend spontaneously. […] Patients with bilateral cryptorchidism should be referred immediately for an evaluation with karyotype and biochemical workup for a difference of sex development (DSD). […] Key diagnostic factors include malpositioned or absent testis, palpable cryptorchid testis, and nonpalpable testis.

• #1 Undescended Testicle: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/parenting/baby/what-is-an-undescended-testicle

  In most cases, your doctor finds the problem as part of a regular check-up soon after birth. […] If your doctor thinks theres a problem, they may try to rule out other causes, such as: […] Your doctor can check for this as part of a physical exam. […] Your doctor will see if they can gently move the testicle into the scrotum with their hand. If they can do that, then its a retractile testicle.

• #1 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) […] Primary care providers should palpate testes for quality and position at each recommended well-child visit. (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 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)

• #1 Cryptorchidism | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/cryptorchidism?lang=us

  Cryptorchidism refers to an absence of a testis (or testes) in the scrotal sac. It may refer to an undescended testis, ectopic testis, or an atrophic or absent testis. Correct localization of the testes is essential because surgical management varies on location. […] Ultrasound has 45% sensitivity, 78% specificity, and 88% accuracy for localization of undescended testis and is more accurate than clinical examination. […] MRI is the best cross-sectional modality to assess crypto-orchidism (replacing CT). It has a higher sensitivity than ultrasound (~90%) and a higher specificity (100%). […] Orchiopexy is the preferred mode of management in case of viable testes high-up in the scrotum or within inguinal canal/abdomen. It is performed after 1 year of age since the testes may descend without intervention.

• #1 Pathology Outlines – Cryptorchidism

  https://www.pathologyoutlines.com/topic/testiscryptorchidism.html

  Absence of one or both testes in the scrotum. […] Most common congenital abnormality of the genitourinary tract (Transl Pediatr 2016;5:233). […] Associated with infertility and subfertility, testicular germ cell tumor, testicular torsion and inguinal hernia. […] Absence of one or both testes in the scrotum most commonly due to failure of descent into the scrotum during fetal development. […] Increased risk of reduced fertility and testicular germ cell tumor. […] Laparoscopy is gold standard in diagnosing a nonpalpable testis. […] Ultrasound and other radiologic imaging are not sensitive in diagnosing a nonpalpable testis (Pediatrics 2011;127:119, Pediatrics 2013;131:e1908). […] Must exclude retractile testis, a testis that has descended into the scrotum but has been pulled superiorly by cremaster muscle. […] In bilateral cryptorchidism, must exclude congenital adrenal hyperplasia and persistent Müllerian duct syndrome.

• #1

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

  Undescended testicles can usually be diagnosed after a physical examination. […] This will determine whether the testicles can be felt near the scrotum (palpable) or if they can’t be felt at all (impalpable). […] This physical examination can sometimes be difficult, so your doctor may need to refer your child to a paediatric surgeon. […] No further scans or tests are needed to locate the testicles if they can be felt by the doctor. […] If they can’t be felt, part of the initial surgical treatment may involve keyhole surgery (a diagnostic laparoscopy) to see if the testicles are inside the abdomen.

• #1 Diagnostic Imaging in Cryptorchidism: Utility, Indications, and Effectiveness

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3712862/

  With only rare reports of an inguinal testis misidentified during surgical exploration, laparoscopy has nearly 100% sensitivity and specificity to localize a testis or confirm its absence. […] However, if diagnostic imaging could reliably determine the presence and location of a non-palpable testis, a child could be spared an operation (in the setting of an absent testis) or could undergo a more limited operation restricted to where the testis was seen on pre-operative imaging evaluation. […] Ultrasound is an appropriate screening evaluation for children with ambiguous genitalia or hypospadias and cryptorchidism. […] Future studies should examine whether pre-operative MRI has utility in re-operative orchiopexy.

• #1 The Undescended Testicle: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/1101/p2037.html/1000

  Surgery for the nonpalpable testicle is diagnostic and potentially therapeutic. […] If the absence of a testis is surgically confirmed by identifying blind-ending testicular vessels, the surgery should be terminated. […] The two initial surgical approaches to the nonpalpable testis are the open inguinal and diagnostic laparoscopic techniques.

• #1

  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. […] Usually not. Most often, an undescended testicle diagnosis can be confirmed with a careful physical exam by your child’s doctor. Ultrasound typically is not necessary, even in situations where the testicle cannot be felt in the groin. In fact, an ultrasound may give inaccurate results on the location or presence/absence of a testicle. […] Only in very rare cases is ultrasound helpful, such as before surgery for a previously repaired undescended testicle.

• #1 Cryptorchidism (undescended testicle): Symptoms, risk factors, and ca

  https://www.medicalnewstoday.com/articles/184604

  If both testicles are undescended, the doctor may recommend a genetic test to determine the sex chromosomes. […] In around half of all infants with cryptorchidism, the testicle will descend on its own within 3 months. […] However, in 1 or 2 of every 100 infants with cryptorchidism, the testicle has not descended by the time the baby reaches 6 months of age. […] A surgeon will often use an orchidopexy procedure, or orchiopexy. […] It is important to perform the procedure before the child is 2 years old because delays may increase the long-term risk of testicular cancer or infertility. […] If a testicle does not descend, its temperature can rise high enough to cause a low sperm count or poor sperm quality. […] Testicular cancer is another complication of an undescended testicle, though the risk is lower than 1 percent.

• #1 Cryptorchidism – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/congenital-renal-and-genitourinary-anomalies/cryptorchidism

  Cryptorchidism is failure of one or both testes to descend into the scrotum; in younger children, it is typically accompanied by inguinal hernia. Diagnosis is by testicular examination, sometimes followed by laparoscopy to look for testes that cannot be palpated on examination. […] Eighty percent of undescended testes are diagnosed at birth. The remainder are diagnosed during childhood or early adolescence; these are usually caused by an ectopic gubernacular attachment and become apparent after a somatic growth spurt. […] Diagnosis of cryptorchidism is by physical examination; a warm environment, warm examiners hands, and a relaxed patient are important to avoid stimulating testicular retraction. […] In patients with a unilateral nonpalpable testis, a descended testis that is larger than expected suggests an atrophic undescended testis; confirmation requires surgical intervention typically via diagnostic laparoscopy to seek an intra-abdominal testis or confirm testicular agenesis. […] For bilateral nonpalpable testes, patients in the immediate neonatal period should be evaluated for a possible disorder of sexual differentiation (consultation with a pediatric endocrinologist should be considered). […] Clinical evaluation is usually adequate; imaging is rarely indicated.

• #1

  https://step1.medbullets.com/evidence/11087186

  Early diagnosis and management of the undescended testicle are needed to preserve fertility and improve early detection of testicular malignancy. […] Physical examination of the testicle can be difficult; consultation should be considered if a normal testis cannot be definitely identified. […] By six months of age, patients with undescended testicles should be evaluated by a pediatric urologist or other qualified subspecialist who can assist with diagnosis and treatment. […] Therapy for an undescended testicle should begin between six months and two years of age and may consist of hormone or surgical treatment. […] The success of either form of treatment depends on the position of the testicle at diagnosis. […] Recent improvements in surgical technique, including laparoscopic approaches to diagnosis and treatment, hold the promise of improved outcomes.

• #1 Undescended Testicle

  https://www.healthline.com/health/undescended-testicle

  Your childs doctor may be able to palpate, or feel, his undescended testicle in his abdomen. In other cases, the testicle cant be felt. In some cases, the testicle isnt present at all. […] An X-ray or ultrasound imaging test may help your childs doctor diagnose an undescended testicle. Imaging scans, including an MRI with contrast dye, can confirm the presence or absence of his testicle. […] Two conditions can mimic an undescended testicle. A retractile testicle is one that moves back and forth between your childs groin and his scrotum. This condition typically subsides as your child ages. An ascending testicle is one that returns to your childs groin and cant be easily guided back.

• #1

  https://journals.lww.com/md-journal/fulltext/2024/07050/diagnoses_and_treatment_of_acquired_undescended.20.aspx

  Acquired undescended testes were once considered a sporadic disease. In recent years, reports suggest that they are not uncommon, with an incidence rate about 3 times that of congenital undescended testes. The etiology of acquired undescended testes remains inconclusive, clinical diagnostic standards are unclear, and treatment approaches are still controversial. There are no clear diagnostic standards for acquired undescended testes yet, and spontaneous descent is possible, so testicular fixation surgery may not be the preferred treatment method. The diagnostic criteria for aUDT are in dispute. To distinguish it from cUDT, the following 3 criteria are recommended. A reliable medical history supports the fact that the testicle was once at the bottom of the scrotum. Undescended testes cannot be put back into the scrotum by experienced urologists, even if the patients are under anesthesia. It is impossible to find factors that cause the ascent of testicles on the same side, such as inguinal surgeries, trauma, or inflammation. The top choice of treatment for aUDT remains a controversial issue. Current treatments include orchiopexy, spontaneous testicular descent, and hormone therapy. Despite its sound instant effects, no studies have proved that early ORP treatment can improve patients fertility. Most scholars believe that surgical intervention should be performed immediately after the definitive diagnosis of aUDT, and testicular descent fixation should be performed. However, a systematic evaluation of the long-term effects of testicular descent fixation in aUDT, such as changes in testicular volume and spermatogonial cell counts, is still lacking. In summary, surgical treatment remains the mainstay of therapy for aUDT. However, further studies are needed to examine natural developmental outcomes after the natural descent of aUDT and to analyze long-term outcomes after performing testicular fixation.

• #1 Undescended testicles | Better Health Channel

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

  Undescended testicles are diagnosed at three months of age if the testicle has failed to descend into the scrotum by that time. Undescended testicles are diagnosed by physical examination. In some cases, the missing testicle can be felt in the lower abdomen. […] Your childs GP should check him for acquired undescended testicles around the time that he starts school. However, this condition can occur later in childhood, up to around 10 years of age. If you think that your childs testes may have moved back into his groin (for example, if you cannot see his testes in his scrotum when he is in a warm bath, or if he cannot detect them himself), see a GP.

• #1 The Undescended Testicle: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/1101/p2037.html

  A more recent article on cryptorchidism (undescended testicle) is available. […] Early diagnosis and management of the undescended testicle are needed to preserve fertility and improve early detection of testicular malignancy. […] By six months of age, patients with undescended testicles should be evaluated by a pediatric urologist or other qualified subspecialist who can assist with diagnosis and treatment. […] The success of either form of treatment depends on the position of the testicle at diagnosis. […] Recognition of the condition, identification of associated syndromes, proper diagnostic evaluation and timely referral for urologic surgical therapy are important steps in preventing adverse consequences. […] Treatment for cryptorchidism can be hormonal, surgical or a combination of the two.

• #1 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. […] The true incidence of undescended testicles, after the third month of life when they are most likely to spontaneously descend, is about 1%. […] 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. […] Scrotal ultrasounds are not recommended prior to referral. […] 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.

• #1

  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. […] In most cases, if the testicle can be felt in the groin, a simple orchidopexy can be performed. […] If the testicle is thought to be higher in the tummy (abdomen), a type of keyhole surgery known as a laparoscopy is sometimes carried out to locate it before it’s repositioned.

• #1 Cryptorchidism – Pathophysiology – Managment – TeachMePaediatrics

  https://teachmepaediatrics.com/surgery/urology/cryptorchidism/

  Long term there is a small risk of testicular atrophy and testicular re-ascent. […] Impaired fertility as testis are 2-3 C warmer if intra-abdominal, this can effect spermatogenesis. […] Testicular cancer 2-3 times more common with a history of undescended testis (2-3%), and this risk double if correction is undertaken after puberty. […] Undescended testis are at higher risk of torsion.

• #1 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: […] If a baby’s testicles can’t be found in the scrotum after birth, more tests may be needed. These tests can determine if the testicles are absent meaning not there at all rather than undescended. […] Imaging tests, such as an ultrasound and MRI, usually aren’t needed to find out if a baby has an undescended testicle. […] The goal of treatment is to move the undescended testicle to its proper place in the scrotum. Treatment before age 1 might lower the risk of health problems linked with an undescended testicle, such as infertility and testicular cancer. […] 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).

• #1

  https://www.kkh.com.sg/patient-care/conditions-treatments/undescended-testicles

  The babys doctor will usually check for undescended testicles at birth and at the regular baby reviews. […] Some boys may need a referral to a paediatric surgeon if the testicles are not in position. […] This condition can usually be checked by a doctor during a physical examination alone. In general, scans are not required unless nothing can be felt.

• #1 Undescended testicles: Why prompt referral is key

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

  An estimated 3 percent of boys have undescended testicles at birth, making it a common problem encountered by pediatricians and urologists alike. Also known as cryptorchidism, an undescended testicle is one that hasn’t moved into its proper position in the scrotum before birth. […] For pediatricians, knowing when and how to contact a urologist is crucial since speedy diagnosis and treatment can reduce complications. […] Not seeing or feeling a testicle where you would expect it to be in the scrotum is the main sign of an undescended testicle. […] The bottom line: If you can’t feel or see one or both testicles, it’s best to refer the family to a pediatric urologist for an in-depth examination. […] “Infants with a suspected undescended testis will benefit from an immediate referral to a pediatric urologist, particularly if it hasn’t descended by the time a child is 6 months old,” Dr. Nelson notes.

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

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

  The timing for when your baby gets surgery will depend on many factors. […] Early treatment with surgery seems to lower the risk of later health problems. […] Orchiopexy is the most common surgery to fix a single undescended testicle. It has a success rate of nearly 100%. Most of the time, the risk of fertility problems goes away after surgery for a single undescended testicle. […] If your baby’s testicle hasn’t moved down or can’t be found by about 6 months of age, you may need to see a specialist for more exams.

• #1 Undescended Testes | Riley Children’s Health

  https://www.rileychildrens.org/health-info/undescended-testes

  Some infants are born with testes that have not descended into the scrotum. Instead, one or both remain in the abdominal cavity, the groin or the upper scrotum. This condition is known as undescended testicles or cryptorchidism and is treatable by expert pediatric urologists at Riley at IU Health. […] This condition is usually diagnosed during the first year of life by a parent or pediatrician. Boys are sometimes diagnosed with undescended testes later in childhood or in adolescence. […] The first step in diagnosis for undescended testes is repeated testicular examination. Other diagnostic tools are laparoscopy and, in rare cases, imaging such as ultrasound. […] Undescended testes should not be left untreated, and early treatment is recommended. Surgical correction preserves how testicles produce sperm. Treatment also reduces the risk of testicular cancer, which is slightly higher in boys with undescended testes.

• #1 Undescended testicles and treatment

  https://www.aboutkidshealth.ca/undescended-testicle

  If a child’s testicles have not descended by the time they are three to four months of age, surgery may be needed to prevent fertility problems later in life. […] If your childs testicles have not descended by this time, surgery is advised to correct the issue. […] Undescended testicles are diagnosed by physical exam by a health-care provider. An ultrasound of the testicles is not routinely required to diagnose undescended testicles but may be requested at the discretion of your childs health-care team. […] If the testicle has not descended on its own by three or four months of age, your child may need surgery (orchidopexy). […] Orchidopexy is an operation to lower the testicles into the scrotum. […] Testicles need cool body temperature in the scrotum area to make sperm. An undescended testicle may be too warm to produce healthy sperm. This increases the risk of fertility problems later in life.

• #1 The Undescended Testicle: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/1101/p2037.html

  In the United States, the only hormone labeled for the treatment of cryptorchidism is hCG, which is administered intramuscularly. […] The inguinal orchiopexy is a well-established operation for the palpable undescended testicle. […] Surgery for the nonpalpable testicle is diagnostic and potentially therapeutic. […] If the absence of a testis is surgically confirmed by identifying blind-ending testicular vessels, the surgery should be terminated. […] The two initial surgical approaches to the nonpalpable testis are the open inguinal and diagnostic laparoscopic techniques.

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

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

  Hormonal treatment with gonadotrophin-releasing hormone or human chorionic gonadotropin has been investigated but has not proven efficacious in promoting testicular descent. […] The literature has shown there may be an association between UDT and infertility, but it does not appear to be as great as once feared or as parents are often told, particularly for unilateral UDT. […] 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. […] Investigations are not required prior to referral. […] 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.

• #1 Undescended Testicle: Causes, Treatment and Surgery

  https://dreminozbek.com/en/undescended-testicle-causes-treatment-and-surgery/

  The success rate in orchiopexy surgery is high. It is successful around 95%, complications are extremely low, around 1%. […] In summary; Undescended testis is a common congenital developmental defect of the urogenital system. The most effective treatment is surgery. The success of the surgery is quite high. The surgery should be done within 6-12 months. If left untreated, it causes serious problems such as testicular cancer and infertility in the future.

• #1 Undescended testicles and treatment

  https://www.aboutkidshealth.ca/undescended-testicle

  An undescended testicle also cannot be easily felt or palpated. As children get older, this means they may be unable to self-examine for testicular masses or cancer. […] Your child will be scheduled for routine assessment approximately three months after orchiopexy surgery. This allows enough time for the swelling and discoloration of the surgical site to resolve. […] If you think a diagnosis of undescended testicles has been missed, see your childs primary health-care provider.

• #1 Cryptorchidism | Patient Care

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

  Laparoscopy can be used to localize nonpalpable, undescended testes. The laparoscopy is performed first to find out if the testicle is located in the abdomen or if it is congenitally absent. […] After the initial post-operative visits, children should be seen 1 year after surgery to note the location and size of the testes.

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

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

  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) […] 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 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)

• #1

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

  The operation is slightly less successful in treating impalpable testicles located in the abdomen. […] As with any type of surgery, an orchidopexy carries the risk of complications, some of which may need to be treated with further surgery. […] 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.

• #1 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. This clinical guideline discusses diagnosis and treatment to prevent future risks, including impairment of fertility potential, testicular malignancy, torsion and/or associated inguinal hernia. […] The main reasons for treatment of cryptorchidism include increased risks of impairment of fertility potential, testicular malignancy, torsion and/or associated inguinal hernia. Cryptorchidism has evolved significantly over the past half century, with respect to both diagnosis and treatment. […] 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.

• #2 Cryptorchidism (undescended testicle): Symptoms, risk factors, and ca

  https://www.medicalnewstoday.com/articles/184604

  An undescended testicle has not moved into the scrotum, the bag of skin that hangs behind the penis, during the development of a fetus. […] The American Urological Association report that 34 percent of full-term male newborns and 21 percent of those born prematurely have an undescended testicle. […] The more formal medical term for testicles that do not descend is cryptorchidism. […] Cryptorchidism occurs when one or both of the testicles do not descend into the scrotum while the fetus is developing. […] To diagnose an undescended testicle, the doctor usually places the infant in a warm place to help him relax. […] About 20 percent of the time, a doctor cannot locate the undescended testicle until the child is no longer an infant. […] If the testicle is unpalpable, an ultrasound scan can often show its location.

• #2

  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. […] Usually not. Most often, an undescended testicle diagnosis can be confirmed with a careful physical exam by your child’s doctor. Ultrasound typically is not necessary, even in situations where the testicle cannot be felt in the groin. In fact, an ultrasound may give inaccurate results on the location or presence/absence of a testicle. […] Only in very rare cases is ultrasound helpful, such as before surgery for a previously repaired undescended testicle.

• #2 Cryptorchidism – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/741

  Cryptorchidism diagnosis is made on physical exam when one or both testes are not present within the dependent portion of the scrotal sac. […] Approximately 70% of cryptorchid testes are palpable within the upper portion of the scrotum or inguinal canal, whereas the other 30% are not palpable, suggesting either an intra-abdominal location, testicular nubbin, or anorchia. […] Referral to a specialist should be made by 6 months corrected gestational age and surgical correction should be performed within the next year. Testes that remain undescended by 6 months are unlikely to descend spontaneously. […] Patients with bilateral cryptorchidism should be referred immediately for an evaluation with karyotype and biochemical workup for a difference of sex development (DSD). […] Key diagnostic factors include malpositioned or absent testis, palpable cryptorchid testis, and nonpalpable testis.

• #2 Cryptorchidism – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/741

  Cryptorchidism diagnosis is made on physical examination when one or both testes are not present within the dependent portion of the scrotal sac. […] Approximately 70% of cryptorchid testes are palpable within the upper portion of the scrotum or inguinal canal, whereas the other 30% are not palpable, suggesting either an intra-abdominal location, testicular nubbin, or anorchia. […] Referral to a specialist should be made by 6 months corrected gestational age and surgical correction should be performed within the next year. Testes that remain undescended by 6 months are unlikely to descend spontaneously. […] Patients with bilateral cryptorchidism should be referred immediately for an evaluation with karyotype and biochemical workup for a difference of sex development (DSD). […] Key diagnostic factors include presence of risk factors, malpositioned or absent testis, palpable cryptorchid testis, and non-palpable testis.

• #2 – Health Library | NewYork-Presbyterian

  https://www.nyp.org/healthlibrary/diagnosis-short/document/zm2279

  Undescended testicles are often classified according to their location and whether they can be felt (palpable or nonpalpable). […] An undescended testicle (cryptorchidism) is one that remains inside the body and has not moved down into the scrotum. One or both testicles may be affected. […] Abdominal: The testicle remains inside the abdomen and cannot be felt (is nonpalpable) during a physical exam. It is usually near the inner opening of the inguinal canal. […] Inguinal: The testicle stops in the inguinal canal and usually cannot be felt during a physical exam. […] Prescrotal or prepubic: The testicle moves farther down the inguinal canal but does not descend all the way into the scrotum. It usually can be felt (is palpable) during a physical exam.

• #2 Cryptorchidism – Pathophysiology – Managment – TeachMePaediatrics

  https://teachmepaediatrics.com/surgery/urology/cryptorchidism/

  Sometimes the testis may be found within the groin, along the inguinal canal, but cannot bring it further, therefore an inguinal undescended testis has been found. […] Around 20% of undescended testis are impalpable and are therefore: ectopic, intra-abdominal, absent, or impalpably small. […] No imaging modality has been shown to be of benefit in the diagnosis of undescended testis. […] The intervention is dependent on clinical findings and the suspected position of the undescended testis. […] If unable to find the testis on examination, it is important to identify if the testis is absent or intra-abdominal. […] If the testis is palpable, an open orchidopexy can be performed. […] If the testis is intra-abdominal a single or 2-stage procedure (Fowler-Stephens) can be adopted. […] Short term complications include infection, bleeding and wound dehiscence.

• #2 Undescended Testicle

  https://www.healthline.com/health/undescended-testicle

  Your childs doctor may be able to palpate, or feel, his undescended testicle in his abdomen. In other cases, the testicle cant be felt. In some cases, the testicle isnt present at all. […] An X-ray or ultrasound imaging test may help your childs doctor diagnose an undescended testicle. Imaging scans, including an MRI with contrast dye, can confirm the presence or absence of his testicle. […] Two conditions can mimic an undescended testicle. A retractile testicle is one that moves back and forth between your childs groin and his scrotum. This condition typically subsides as your child ages. An ascending testicle is one that returns to your childs groin and cant be easily guided back.

• #2 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. […] American Urological Association guidelines specifically recommend against routine use of ultrasound for suspected undescended testicles. […] That’s important because the longer the wait before surgery, the higher the risk of complications the child may experience down the road. […] 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.

• #2 Cryptorchidism | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/cryptorchidism?lang=us

  Cryptorchidism refers to an absence of a testis (or testes) in the scrotal sac. It may refer to an undescended testis, ectopic testis, or an atrophic or absent testis. Correct localization of the testes is essential because surgical management varies on location. […] Ultrasound has 45% sensitivity, 78% specificity, and 88% accuracy for localization of undescended testis and is more accurate than clinical examination. […] MRI is the best cross-sectional modality to assess crypto-orchidism (replacing CT). It has a higher sensitivity than ultrasound (~90%) and a higher specificity (100%). […] Orchiopexy is the preferred mode of management in case of viable testes high-up in the scrotum or within inguinal canal/abdomen. It is performed after 1 year of age since the testes may descend without intervention.

• #2 Cryptorchidism | Patient Care

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

  When we see a child with an undescended testicle, the ultimate diagnosis can be classified according to several different categories: […] Generally radiologic imaging is not reliable. Ultrasound can help identify a testicle located in the inguinal canal, but is of limited use for intra-abdominal testes. MRI and CT scan can be useful for intra-abdominal testes, but they are often difficult to use on small children and have a high rate of false negative results. […] 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. […] Surgery is immediately performed on ectopic testes, cryptorchids with coexisting hernias and boys at pubertal age.

• #2 The Undescended Testicle: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/1101/p2037.html

  In the United States, the only hormone labeled for the treatment of cryptorchidism is hCG, which is administered intramuscularly. […] The inguinal orchiopexy is a well-established operation for the palpable undescended testicle. […] Surgery for the nonpalpable testicle is diagnostic and potentially therapeutic. […] If the absence of a testis is surgically confirmed by identifying blind-ending testicular vessels, the surgery should be terminated. […] The two initial surgical approaches to the nonpalpable testis are the open inguinal and diagnostic laparoscopic techniques.

• #2 Everything you need to know about Undescended Testes | The Pelvic Specialists

  https://thepelvicspecialists.co.uk/blog/undescended-testes-2/

  If the ultrasound does not provide a clear diagnosis, the doctor may recommend a laparoscopy. A laparoscopy is a minimally invasive surgical procedure that uses a small camera to view the inside of the abdomen. During the procedure, the doctor will make a small incision in the baby boys abdomen and insert a laparoscope, which is a thin, lighted tube with a camera on the end. The doctor will use the camera to view the inside of the abdomen and locate the testicles.

• #2 Undescended testes (Cryptorchidism) in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/undescended-testes-cryptorchidism-in-neonates

  Undescended testes (UDT) are a common finding in the neonatal period. In most cases the aetiology is unknown. […] Refer to surgical services if a palpable UDT fails to descend by three months of age or if the testis is non-palpable. […] Exclude the diagnosis of ambiguous genitalia. […] Imaging studies are rarely of use in identifying a non-palpable UDT. […] Immediate endocrine referral and further investigations are necessary if undescended testes are associated with ambiguous genitalia. […] Failure to descend by approximately three months of age is considered abnormal, and these infants should be referred for surgical opinion. […] The optimal time for orchidopexy is at about six to 12 months of age. […] Although surgery to place the testis in the scrotum may not reduce the risk of infertility or malignancy, it improves the endocrine function of the testis and facilitates testicular self-examination. […] Surgical exploration (laparoscopy) for the non-palpable testis is warranted as in approximately half of these cases the testis may be salvaged.

• #2 Pathology Outlines – Cryptorchidism

  https://www.pathologyoutlines.com/topic/testiscryptorchidism.html

  Absence of one or both testes in the scrotum. […] Most common congenital abnormality of the genitourinary tract (Transl Pediatr 2016;5:233). […] Associated with infertility and subfertility, testicular germ cell tumor, testicular torsion and inguinal hernia. […] Absence of one or both testes in the scrotum most commonly due to failure of descent into the scrotum during fetal development. […] Increased risk of reduced fertility and testicular germ cell tumor. […] Laparoscopy is gold standard in diagnosing a nonpalpable testis. […] Ultrasound and other radiologic imaging are not sensitive in diagnosing a nonpalpable testis (Pediatrics 2011;127:119, Pediatrics 2013;131:e1908). […] Must exclude retractile testis, a testis that has descended into the scrotum but has been pulled superiorly by cremaster muscle. […] In bilateral cryptorchidism, must exclude congenital adrenal hyperplasia and persistent Müllerian duct syndrome.

• #2 Undescended Testis | Symptoms, Diagnosis & Treatment

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

  During the unborn male’s development, the testicles are located in the belly. They slowly move down into the scrotum during the seventh month of pregnancy. Undescended testicles (cryptorchidism) refer to a condition in which the testicle does not drop and cannot be brought into the scrotum with external manipulation. Parents or the child’s doctor can find a testicle that hasn’t dropped during a physical exam. Often, no testicle can be felt; this condition is called a non-palpable testicle (unable to be felt on examination of the scrotal sac). […] The exam shows an inguinal hernia (an opening in the lower belly wall or inguinal canal where the intestines may stick out) as well.

• #2 Causes, symptoms and details of Undescended Testes – Pulse Reference

  https://pulsereference.com/diagnoses/undescended-testes/

  Undescended testes, also known as cryptorchidism, refer to a congenital condition in which one or both testicles fail to descend into the scrotum by the time of birth. The diagnostic criteria for undescended testes include a physical examination to confirm the absence of one or both testes in the scrotum at birth or within the first few months of life. […] Clinical examination is key in the diagnosis of undescended testes. GPs should perform a thorough physical examination, particularly during routine well-baby checks. Palpation of the scrotum and inguinal canal is essential to identify the presence and location of the testes. A non-palpable testis may indicate an abdominal or absent testis, while a palpable testis may suggest an inguinal or high scrotal location. […] If there is any uncertainty in differentiating between a possible undescended testis and retractile testis, arrange referral for clarification of the diagnosis.

• #2 Cryptorchidism – Pathophysiology – Managment – TeachMePaediatrics

  https://teachmepaediatrics.com/surgery/urology/cryptorchidism/

  Cryptorchidism is a congenital absence of one or both testes in the scrotum due to a failure of the testes to descend during development. […] Cryptorchidism, or the failure of testicular descent into the scrotum, is a surgical condition found in 6% of newborns, but drops to 1.5-3.5% of males at 3 months. […] One of the key elements in the history is to clarify if the testis has ever been seen or palpated within the scrotum, such as in the newborn check. […] Initial inspection may reveal testis within the scrotum, therefore a diagnosis of retractile or normal descended testis can be made. […] Around 80% of undescended testis are palpable, therefore should be found with a good examination. […] If found, one should attempt to see if the testis can be gently milked down to the base of the scrotum, in which case a diagnosis of retractile testis can be made, if it is pulled down but under tension in the base, this commonly referred to as a high scrotal or simply high testis.

• #2 Undescended Testicles | Cryptorchidism – Causes, Complications, Diagnosis, Treatment

  https://www.medindia.net/health/conditions/undescended-testicles.htm

  A normal physical exam at birth or shortly after by the doctor helps in diagnosing undescended testis. […] In 30% of boys, the undescended testicle cannot be located because it is well inside the abdomen or missing or very small. […] When the testicle cannot be located, it is called non palpable or missing. […] It could also be that the testicle has followed a non-standard path and descended in an abnormal location outside the scrotum like the lower part of the abdomen, front of the thigh, femoral canal, skin of penis or behind the scrotum. […] In most cases the testicle is developed but associated with indirect inguinal hernia. […] In the case of an undescended testicle that can be located, one can wait for 3-6 months for spontaneous descent. If this does not happen, it is essential to consult a pediatric urologist.

• #2 Undescended Testes | Riley Children’s Health

  https://www.rileychildrens.org/health-info/undescended-testes

  Only a small percentage of children need treatment for undescended testes. […] Undescended testes are usually diagnosed during the first year of life, but occasionally this condition is not detected until the age of 10 or even in adolescence. […] If treatment is needed, it can be as simple as laparoscopic surgery or an open surgery to move the testicle into the scrotum.

• #2

  https://step1.medbullets.com/evidence/11087186

  Early diagnosis and management of the undescended testicle are needed to preserve fertility and improve early detection of testicular malignancy. […] Physical examination of the testicle can be difficult; consultation should be considered if a normal testis cannot be definitely identified. […] By six months of age, patients with undescended testicles should be evaluated by a pediatric urologist or other qualified subspecialist who can assist with diagnosis and treatment. […] Therapy for an undescended testicle should begin between six months and two years of age and may consist of hormone or surgical treatment. […] The success of either form of treatment depends on the position of the testicle at diagnosis. […] Recent improvements in surgical technique, including laparoscopic approaches to diagnosis and treatment, hold the promise of improved outcomes.

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

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

  Undescended testis (UDT) is a common condition, and parents often primarily present to general practitioners. […] The aim of this article is to summarise the key points of assessment and management of UDT in the primary care setting. […] Current evidence does not support the use of ultrasonography prior to referral. […] Ideally, the physical examination should be done in a warm environment and when the child is calm. […] A significant suprapubic fat pad can influence the examination and make a UDT difficult to detect. […] Classify the testis as normal, high scrotal, supra-scrotal or impalpable. […] Ultrasonography is not helpful prior to referral. […] Current guidelines recommend referral at 36 months for unilateral UDT, and orchidopexy between six and 12 months. […] Examination under anaesthesia and diagnostic laparoscopy is the treatment for impalpable testes.

• #2 Cryptorchidism: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438378-overview

  Cryptorchidism is the most common genital problem encountered in pediatrics. Cryptorchidism literally means hidden or obscure testis and generally refers to an undescended or maldescended testis. […] Understanding the abnormalities of morphogenesis and the molecular and hormonal milieu associated with cryptorchidism is critical to contemporary diagnosis and treatment of this extremely common entity. […] Imaging for cryptorchidism is not recommended prior to referral. […] Successful scrotal repositioning of the testis may reduce but does not prevent the potential long-term issues of infertility and testicular cancer. […] An undescended testis may descend spontaneously during the first few months of life but is unlikely to do so after 6 months (corrected for gestational age). […] The etiology of cryptorchidism is multifactorial.

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

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

  Not seeing or feeling a testicle in the scrotum is the main symptom of an undescended testicle. […] An undescended testicle often is found during an exam done shortly after birth. If your baby has an undescended testicle, ask how often exams will need to be done. If the testicle hasn’t moved into the scrotum by 3 to 4 months of age, the condition likely won’t correct itself. […] Treating an undescended testicle when your child is still a baby might lower the risk of health problems later in life. […] The exact cause of an undescended testicle isn’t known. […] The testicles need to be slightly cooler than regular body temperature to develop and work well. […] Men who’ve had an undescended testicle have a higher risk of testicular cancer. […] Surgery to correct an undescended testicle might lower the risk of testicular cancer. […] Fertility problems make it harder to get a partner pregnant. They’re more likely to happen in men who’ve had an undescended testicle.

• #2 Cryptorchidism | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/cryptorchidism?lang=us

  With cryptorchidism, there is a 32x increased risk of developing a testicular germ cell tumor, with an incidence of 1 in 2000 (higher in bilateral cases, and in abdominal cryptorchidism). The effect of surgical correction, decreasing the risk of malignancy is controversial but it does allow for easier examination, and – hopefully – earlier detection.

• #2 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. […] Your childs healthcare provider can diagnose undescended testicles during a physical examination at birth or shortly after birth. If they cant feel the testicles (impalpable), your child may have undescended testicles. […] An orchiopexy is the gold-standard undescended testicle treatment. […] If your childs testicles havent dropped by the time theyre 6 months old, talk to a healthcare provider about treatment.

• #2

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

  Undescended testicles can usually be diagnosed after a physical examination. […] This will determine whether the testicles can be felt near the scrotum (palpable) or if they can’t be felt at all (impalpable). […] This physical examination can sometimes be difficult, so your doctor may need to refer your child to a paediatric surgeon. […] No further scans or tests are needed to locate the testicles if they can be felt by the doctor. […] If they can’t be felt, part of the initial surgical treatment may involve keyhole surgery (a diagnostic laparoscopy) to see if the testicles are inside the abdomen.

• #2 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. […] The true incidence of undescended testicles, after the third month of life when they are most likely to spontaneously descend, is about 1%. […] 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. […] Scrotal ultrasounds are not recommended prior to referral. […] 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.

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

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

  How are undescended testicles diagnosed? […] A primary care doctor will first perform a full genital examination and will try to locate the testicle if it is not in the scrotum. If one can’t be felt, your son may be referred to a pediatric urologist or pediatric surgeon for a more complete examination and to rule out two related conditions etopic testicles and retractile testicles. […] If the testicle can be felt in the groin, orchiopexy will probably be done through a small incision in the groin. The surgeon will free the testicle from its location in the abdomen and maneuver it into the scrotum. […] If your child’s testicle does not descend on its own, his surgeon will most likely recommend surgery to move it down into the scrotum around your baby’s first birthday. The surgery, called orchiopexy, reduces long-term effects including risk of cancer or infertility, and will improve your son’s body image through adolescence and adulthood. […] Orchiopexy also makes it possible for young men to easily and routinely examine their testes to detect any abnormalities such as testicular cancer.

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

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

  If testicles dont drop into the scrotum, they may not function properly or produce healthy sperm. They can cause infertility later in life. […] 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.

• #2 Undescended Testicle: Causes, Treatment and Surgery

  https://dreminozbek.com/en/undescended-testicle-causes-treatment-and-surgery/

  Undescended testis (chriptorchidism) is one of the congenital anomalies (developmental disorder) of the urogenital system that is common in boys. Early diagnosis and treatment is very important as it may cause serious complications in the future. […] Early diagnosis of undescended testis and timely treatment planning are very important to prevent future complications. The steps to be followed for diagnosis are as follows; […] The most effective treatment in children with undescended testicles is surgery. The operation performed to lower the testis to its normal place is called orchiopexy surgery (pexy if it is orchioyor). […] Orchiopexy surgery reduces the risk of testicular cancer, but does not completely eliminate it. Therefore, these patients should be checked at regular intervals.

• #2 Undescended Testes (Maldescended and Retractile Testes)

  https://patient.info/doctor/undescended-and-maldescended-testes

  The ideal management of cryptorchidism is a highly debated topic within the field of paediatric surgery. […] However, despite early diagnosis in many patients with undescended testes, many are still referred and operated after 1 year of age. […] Testicular descent is hormonally dependent. […] Treatment with human chorionic gonadotrophin (hCG) or gonadotrophin-releasing hormone (GnRH) can be used. […] The ideal management of cryptorchidism is still a highly debated topic within the field of paediatric surgery. […] If the testis is palpable: an inguinal approach is usually used. […] If the testis is non-palpable: examination under anaesthetic may reveal the previously non-palpable testis.

• #2 Undescended Testicle Repair – UF Health

  https://ufhealth.org/conditions-and-treatments/undescended-testicle-repair

  Undescended testicle repair surgery is recommended for males whose testicles do not descend on their own. […] This surgery is recommended for infants older than 1 year whose testicles have not descended into the scrotum (cryptorchidism). […] Men who have had undescended testicles should do monthly self-exams for the rest of their lives to look for possible tumors. […] There is also a higher risk for testicular cancer in the other testicle that descended normally.

• #2 Undescended Testicles (Cryptorchidism) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/cryptorchidism.html

  Undescended testicles (also known as cryptorchidism) is a condition in which one or both of a baby boy’s testicles (testes) have not moved down into their proper place in the scrotum. […] Doctors usually diagnose undescended testicles (cryptorchidism) during a physical exam at birth or at a checkup shortly after. Most undescended testicles can be located or „palpated” on exam by the doctor. […] If a testicle has not descended on its own by the time a baby is 6 months old, he should be checked by a pediatric specialist and have treatment if the condition is confirmed. This usually involves surgically repositioning the testicle into the scrotum. […] Most doctors believe that boys who’ve had a single undescended testicle will have normal fertility and testicular function as adults, while those who’ve had two undescended testicles might be more likely to have reduced fertility.

• #2 Undescended Testicle Symptoms, Doctors, Treatments, Advances & More | MediFind

  https://www.medifind.com/conditions/undescended-testicle/6241

  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. […] Most of the time, the problem goes away without treatment. Medicine or surgery to correct the condition is successful in most cases. […] In about 50% of males with undescended testicles, the testicles cannot be found at the time of surgery. This is called a vanished or absent testis. […] Complications may include: Damage to the testicle from surgery, Infertility later in life, Testicular cancer in one or both testes. […] Contact your child’s provider if he appears to have an undescended testicle.

• #2 Cryptorchidism – Pathophysiology – Managment – TeachMePaediatrics

  https://teachmepaediatrics.com/surgery/urology/cryptorchidism/

  Long term there is a small risk of testicular atrophy and testicular re-ascent. […] Impaired fertility as testis are 2-3 C warmer if intra-abdominal, this can effect spermatogenesis. […] Testicular cancer 2-3 times more common with a history of undescended testis (2-3%), and this risk double if correction is undertaken after puberty. […] Undescended testis are at higher risk of torsion.

• #2 Undescended Testicle Symptoms and Treatment – Assoc. Prof. A. Kadir Tepeler

  https://www.drtepeler.com/en/undescended-testicle-symptoms-and-treatment/

  Under normal conditions, the testis is expected to descend within 1 year at the latest. However, it is recommended to treat the testicles that do not fall into place during this period. The treatment option is surgery. […] The ideal age range for this surgery is 6-18 months. […] The ideal age for surgery for children with undescended testicles is 6-18 months. As the age of treatment is delayed, the probability of damage to the testis increases.

• #3 Cryptorchidsm / Undescended Testes | ColumbiaDoctors

  https://www.columbiadoctors.org/treatments-conditions/cryptorchidsm-undescended-testes

  Diagnosis is made based on a complete medical history and physical examination. […] We determine specific treatments for undescended testes based on: […] Surgical repair is an operation to locate the undescended testicle and advance it to the scrotal sac. Called orchiopexy, the surgery is usually performed in children between 6 and 18 months old and is successful in 98 percent of our patients.

• #3 Cryptorchidism | Patient Care

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

  When we see a child with an undescended testicle, the ultimate diagnosis can be classified according to several different categories: […] Generally radiologic imaging is not reliable. Ultrasound can help identify a testicle located in the inguinal canal, but is of limited use for intra-abdominal testes. MRI and CT scan can be useful for intra-abdominal testes, but they are often difficult to use on small children and have a high rate of false negative results. […] 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. […] Surgery is immediately performed on ectopic testes, cryptorchids with coexisting hernias and boys at pubertal age.

• #3 Cryptorchidism – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/741

  1st investigations to order include clinical diagnosis. […] Investigations to consider include ultrasound, magnetic resonance imaging (MRI), hormonal evaluation with human chorionic gonadotropin (hCG) stimulation test, hormonal evaluation with Mullerian inhibiting substance (MIS), inhibin B, and follicle-stimulating hormone (FSH), and karyotyping.

• #3 Cryptorchidism: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/438378-overview

  Birth weight is the principal determining factor for undescended testes at birth to age 1 year, independent of the length of gestation. […] In cryptorchidism, the most useful determination is whether the testes are palpable upon physical examination. […] Approximately 80% of undescended testes are palpable and 20% are nonpalpable. […] Indications for hormonal or surgical correction of cryptorchidism are described below. […] Early reposition of the testis into the scrotum has been a mainstay of treatment to reduce the risk of infertility; however, even with successful orchidopexy at age 6-12 months, 20-25% of boys with nonsyndromic cryptorchidism have compromised fertility potential. […] Males with undescended testis are 40 times as likely to develop testicular cancer as males without undescended testis. […] Prepubertal orchiopexy reduces this risk. […] The location of the undescended testis affects the relative risk of testicular cancer. Up to 50% of malignant testicular tumors associated with cryptorchidism involve intra-abdominal testes.

• #3

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

  A testicle found inside the abdomen can occasionally be brought down to the scrotum in a single operation, but sometimes this has to be done in 2 separate stages. […] In cases where the testicle is in the abdomen (impalpable), there’s a small possibility that there’s no testicle at all on that side. […] This would be confirmed during the laparoscopy. […] 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. […] The success rate for treating palpable testicles located near the scrotum is estimated to be higher than 90%.

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