Undescended Testes

Abstract

Approximately 1.5 % of boys undergo treatment for an undescended testis (UDT). The primary purpose of performing an orchiopexy is to maximize the potential for fertility, by allowing gonocytes to develop into mature sperm. The longer orchiopexy is delayed, the lower the potential for fertility. Following unilateral orchiopexy, approximately 90 % are fertile in adulthood, whereas only 65 % of men who underwent bilateral orchiopexy are fertile. There also is an elevated risk of testicular cancer, even following successful orchiopexy. In boys with a nonpalpable testis, approximately 50 % are abdominal or high in the inguinal canal, whereas 50 % are atrophic in the scrotum or inguinal canal secondary to spermatic cord torsion in utero. Imaging (e.g., ultrasound) is rarely indicated in boys with a nonpalpable testis. Hormonal therapy is rarely used in boys with a UDT. Referral by 6–12 months of age is appropriate.