The undescended testicle: Diagnosis and management

Early diagnosis and management of the undescended testicle are needed to pr eserve fertility and improve early detection of testicular malignancy. Phys ical examination of the testicle can be difficult; consultation should be c onsidered if a normal testis cannot be definitely identified. Observation i s not recommended beyond one year of age by cause it delays treatment, lowe rs the rate of surgical success and probably impairs spermatogenesis. By si x 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. Earlier referral may be warranted for bilateral n onpalpable testes in the newborn or for any child with both hypospadias and an undescended testis. Therapy for an undescended testicle should begin be tween six months and two years of age and may consist of hormone or surgica l treatment. The success of either form of treatment depends on the positio n of the testicle at diagnosis. Recent improvements in surgical technique, including laparoscopic approaches to diagnosis and treatment, hold the prom ise of improved outcomes. While orchiopexy may not protect patients from de veloping testicular malignancy, the procedure allows for earlier detection through self-examination of the testicle!;.