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.
Boys with newly acquired (ascended) testicles should be referred to a surgical specialist.
Delayed or lack of treatment has been associated with a higher incidence of testicular cancer and reduced fertility from the affected testis.
Immediate specialist consultation should be obtained in any patient with bilateral non-palpable testicles.
Patients affected with both cryptorchidism and hypospadias should be screened with karyotype for a disorder of sex development (DSD).
Cryptorchidism, or undescended testis, is when one or both testes are not present within the dependent portion of the scrotal sac.
History and exam
David J. Chalmers, MD
Maine Medical Center
DJC declares that he has no competing interests.
Dr David J. Chalmers would like to gratefully acknowledge Dr Gabriel Belanger, Dr Duncan T. Wilcox, and Dr Nicol Corbin Bush, previous contributors to this topic.
DTW and NCB declare that they have no competing interests.
Martin Koyle, MD
Professor Pediatric Urology
Hospital for Sick Children
MK declares that he has no competing interests.
Paul J. Turek, MD
Professor of Urology
The University of California
PJT declares that he has no competing interests.
Vincent Gnanapragasam, MBBS, BMedSci, PhD, FRCSEng, FRCSEd(Urol)
Lecturer in Uro-oncology and Consultant Urological Surgeon
Department of Urology
VG declares that he has no competing interests.
Jørgen Thorup, MD, PhD
Professor and Head
Department of Pediatric Surgery
Rigshospitalet, University of Copenhagen
JT is an author of a reference cited in this topic.
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