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Undescended Testicle
Diagnosis/Definition
- Failure of the normal testicle to descend into a dependent position in the scrotum. The testicle may be PALPABLE or NONPALPABLE, retractile, ectopic.
- Natural History: In a term male infant, the incidence of undescended testicle (UDT) is just under 4%. By age 1, the incidence drops to 1%; the likelihood of descent of the testicle after age 1 is less than 15% therefore, 75% of testicles undescended at birth will descend spontaneously without surgical or hormonal treatment. If premature, the newborn incidence of undescended testicle can rise to 25-35%.
Initial Diagnosis and Management
Diagnosis: By suspicion and examination with warm hands in a warm nonthreatening environment.
Management: Urology referral for evaluation and management recommendations NOTE: Almost all undescended testes are associated with communicating hydroceles and hernias.
Ongoing Management and Objectives
Normal placement of testes
Advantages:
- Testicle can be properly examined (markedly increased malignancy potential in UDTs)
- Reduced risk of trauma
- Reduced risk of infertility
- Cosmetic benefit
Indications for Specialty Care Referral
All patients with suspected UDTs should be referred by 6 months of age for confirmation, further discussion, and planning
All patients with bilaterally nonpalpable tests require immediate referral
Criteria for Return to Primary Care
Full surgical recovery
Annual exam (self or primary care) and size comparisons advised
